Abstract
This paper selectively reviews the economic research on individual (i.e., diabetes prevention programs and financial rewards for weight loss) and population-wide based diabetes prevention interventions (such as food taxes, nutritional labeling, and worksite wellness programs) that demonstrate a direct reduction in diabetes incidence or improvements in diabetes risk factors such as weight, glucose or glycated hemoglobin. The paper suggests a framework to guide decision makers on how to use the available evidence to determine the optimal allocation of resources across population-wide and individual-based interventions. This framework should also assist in the discussion of what parameters are needed from research to inform decision-making on what might be the optimal mix of strategies to reduce diabetes prevalence.
Highlights
High risk of diabetes imposes high health risks and economic burden
A literature search in PubMed to identify relevant articles published in English between January 2000 and October 2017 using the following key terms to denote well known individual and population level interventions and type two diabetes returns more than 15,000 articles
The Finnish study had reported similar numbers a year earlier: the average proportion of subjects in whom impaired glucose tolerance progressed to diabetes was 3% per year in the intervention group and 6% per year in the control group
Summary
High risk of diabetes imposes high health risks and economic burden. Progression from impaired glucose to type 2 diabetes increases the risks of CVD and other diabetes-related complications which leads to high medical costs, and other economic losses (e.g., absenteeism and presentism in the labor force). There is enough evidence to show that sugary drinks are a major contributor to the obesity epidemic [9] yet the evidence on SSBs (sugary sweetened beverages) taxes on diabetes incidence is not available Because of these caveats and gaps in the literature, it is important to outline a framework that highlights the type of parameters that are important for cost-effective decision making and that can guide us through the best allocation of public resources by championing effective policies over poor ones. Comparing the efficacy of individual and population level strategies for diabetes prevention is important for budget allocation and to strengthen efforts to slow the rate of increase of diabetes prevalence.
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