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Diabetes Lifestyle interventions

Prevent Pre-diabetes to Diabetes transition
Gillies, C.L., Abrams, K.R., Lambert, P.C., Cooper, N.J., Sutton, A.J., Hsu, R.T., Khunti, K., 2007. Pharmacological and lifestyle interventions to prevent or delay type 2 diabetes in people with impaired glucose tolerance: systematic review and meta-analysis. BMJ 334, 299. doi:10.1136/bmj.39063.6893

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Gillies et al BMJ 2007 Pharmacological and lifestyle Interventions to prevent or d

the absolute difference in incidence of diabetes, in terms of percentage points, would be 15.8 (95% credible interval 19.8 to 11.9) for lifestyle intervention. The numbers needed to treat were 6.4 (95% credible interval NNTB 5.0 to NNTB 8.4) for lifestyle

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Restricted Influence control of diabetes in already diagnosed diabetics:

http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0035203/

US Centers for Medicare & Medicaid Services 2012:

HTA by US CMS on lifestyle interventions

For lifestyle interventions that included medicadtion, the results were statistically significant in favour of lifestyle for fasting plasma glucose, HDL cholesterol and HbA1c. - by end of intervention, effect size 0.77% mean difference in HbA1c levels.

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To model diabetes should use, e.g. US CDC RTI model:

Jones, A.P., Homer, J.B., Murphy, D.L., Essien, J.D.K., Milstein, B., Seville, D.A., 2006. Understanding Diabetes Population Dynamics Through Simulation Modeling and Experimentation. Am J Public Health 96, 488494. doi:10.2105/AJPH.2005.063529

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Use population projection figures for BMI / age / (ethnicity)

Appuhamy, J.A.D.R.N., Kebreab, E., France, J., 2013. A mathematical model for determining age-specific diabetes incidence and prevalence using body mass index. Annals of Epidemiology 23, 248254. doi:10.1016/j.annepidem.2013.03.011

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Further:

Abstract
Introduction Healthy People 2010 (HP 2010) objectives call for a 38% reduction in the prevalence of diagnosed diabetes mellitus, type 1 and type 2, by the year 2010. The process for setting this objective, however, did not focus on the achievability or the compatibility of this objective with other national public health objectives. We used a dynamic simulation model to explore plausible trajectories for diabetes prevalence in the wake of rising levels of obesity in the U.S. population. The model helps to interpret historic trends in diabetes prevalence in the United States and to anticipate plausible future trends through 2010. Methods We conducted simulation experiments using a computer model of diabetes population dynamics to 1) track the rates at which people develop diabetes, are diagnosed with the disease, and die, and 2) assess the effects of various preventive-care interventions. System dynamics modeling methodology based on data from multiple sources guided the analyses. Results With the number of new cases of diabetes being much greater than the number of deaths among those with the disease, the prevalence of diagnosed diabetes in the United States is likely to continue to increase. Even a 29% reduction in the number of new cases (the HP 2010 objective) would only slow the growth, not reverse it. Increased diabetes detection rates or decreased mortality rates also HP 2010 objectives would further increase diagnosed prevalence. Conclusion The HP 2010 objective for reducing diabetes prevalence is unattainable given the historical processes that are affecting incidence, diagnosis, and mortality, and even a zero-growth future is unlikely. System dynamics modeling shows why interventions to protect against chronic diseases have only gradual effects on their diagnosed prevalence

Milstein, B., Jones, A., Homer, J.B., Murphy, D., Essien, J., Seville, D., 2007. Charting plausible futures for diabetes prevalence in the United States: a role for system dynamics simulation modeling. Prev Chronic Dis 4, A52.

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Or UCLA HFT model

Shi, L., van Meijgaard, J., Fielding, J., 2011. Forecasting diabetes prevalence in California: a microsimulation. Prev Chronic Dis 8, A80. Should incorporate modelling of likely diabetes prevalence based on census data and: The application of these data depended on a transition matrix that was based on a literature review. This matrix contains estimates of the rates of transition from having no diabetes, prediabetes, and undiagnosed diabetes to having diagnosed diabetes, as well as the risk of mortality associated with different glycemic and diabetic states.

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Boyle, J.P., Thompson, T.J., Gregg, E.W., Barker, L.E., Williamson, D.F., 2010. Projection of the year 2050 burden of diabetes in the US adult population: dynamic modeling of incidence, mortality, and prediabetes prevalence. Population Health Metrics 8, 29. doi:10.1186/1478-7954-8-29

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