T2D prevention by physical activity or diet or both proved cost-effective according to accepted thresholds , except for five inconclusive studies , three on diabetes prevention and two on obesity control .
This confirms that lifestyle interventions for the primary prevention of diabetes are cost-effective .
To summarize key findings of economic evaluations of lifestyle interventions for the primary prevention of  type 2 diabetes ( T2D ) in high-risk subjects .
Effectiveness and cost-effectiveness of diabetes prevention among adherent participants.
OBJECTIVES We report the 10-year effectiveness and within-trial cost-effectiveness of the Diabetes Prevention Program ( DPP ) and its Outcomes Study ( DPPOS ) interventions among participants who were adherent to the interventions . STUDY DESIGN DPP was a 3-year r and omized clinical trial followed by 7 years of open-label modified intervention follow-up . METHODS Data on re source utilization , cost , and quality of life were collected prospect ively . Economic analyses were performed from health system and societal perspectives . Lifestyle adherence was defined as achieving and maintaining a 5 % reduction in initial body weight , and metformin adherence as taking metformin at 80 % of study visits . RESULTS The relative risk reduction was 49.4 % among adherent lifestyle participants and 20.8 % among adherent metformin participants compared with placebo . Over 10 years , the cumulative , undiscounted , per capita direct medical costs of the interventions , as implemented during the DPP , were greater for adherent lifestyle participants ( $ 4810 ) than adherent metformin participants ( $ 2934 ) or placebo ( $ 768 ) . Over 10 years , the cumulative , per capita non-interventionrelated direct medical costs were $ 4250 greater for placebo participants compared with adherent lifestyle participants and $ 3251 greater compared with adherent metformin participants . The cumulative quality -adjusted life-years ( QALYs ) accrued over 10 years were greater for lifestyle ( 6.80 ) than metformin ( 6.74 ) or placebo ( 6.67 ) . Without discounting , from a modified societal perspective ( excluding participant time ) and a full societal perspective ( including participant time ) , lifestyle cost < $ 5000 per QALY-gained and metformin was cost saving compared with placebo . CONCLUSIONS Over 10 years , lifestyle intervention and metformin were cost-effective or cost saving compared with placebo . These analyses confirm that lifestyle and metformin represent a good value for money
T2D prevention by physical activity or diet or both proved cost-effective according to accepted thresholds , except for five inconclusive studies , three on diabetes prevention and two on obesity control .
This confirms that lifestyle interventions for the primary prevention of diabetes are cost-effective .
To summarize key findings of economic evaluations of lifestyle interventions for the primary prevention of  type 2 diabetes ( T2D ) in high-risk subjects .