Prediabetes: Implications for managed care

Mark A. Munger, Laura Shane-Mcwhorter, Carrie Mcadam-Marx

Research output: Contribution to journalReview articlepeer-review

Abstract

Objective: To summarize the clinical and economic implications of prediabetes, including interventions for diabetes prevention. Study design: Literature review. Methods: Searches of the US National Library of Medicine PubMed database were conducted to identify studies that evaluated the clinical implications of prediabetes (impaired glucose tolerance and/or impaired fasting glucose concentration); the economic implications of diabetes and prediabetes; lifestyle and pharmacologic strategies for prevention or delay of onset of type 2 diabetes; and cost analyses of diabetes prevention. Results: Prediabetes is a common and costly condition that typically converts to overt diabetes, which is associated with well-known complications. Moreover, prediabetes is associated with microvascular and macrovascular risks. Statistically signifi cant reductions in new-onset diabetes have been reported for prediabetes patients participating in clinical trials that evaluated lifestyle modifi cations or pharmacologic agents, including antihyperglycemics and orlistat (a weight-loss agent). In addition, renin-angiotensin-aldosterone system inhibitors and antihyperlipidemics offer the potential to prevent diabetes while treating hypertension and dyslipidemia, common high-risk cardiovascular comorbidities. Cursory evidence suggests that interventions targeting the prediabetes population may decrease costs for healthcare systems and society. Conclusion: Prediabetes poses a signifi cant clinical and economic health burden that might be ameliorated with lifestyle and pharmacologic interventions.

Original languageEnglish (US)
Pages (from-to)429-441
Number of pages13
JournalAmerican Journal of Pharmacy Benefits
Volume2
Issue number7
StatePublished - Dec 2010

ASJC Scopus subject areas

  • Business and International Management
  • Pharmacology, Toxicology and Pharmaceutics (miscellaneous)
  • Decision Sciences (miscellaneous)

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