Melanie Y Bertram1, Theo Vos. 1. Centre for Burden of Disease and Cost-Effectiveness, School of Population Health, Edith Cavell Building, Herston Rd, Herston QLD 4006. m.bertram@sph.uq.edu.au
Abstract
OBJECTIVE: Interventions for individuals with pre-diabetes are efficacious, however, identification of people with pre-diabetes does not occur in Australia. This study aims to calculate the duration of pre-diabetes, in order to provide supporting evidence for a screening program. METHODS: We carried out a systematic review and random effects meta-analysis to identify if an increased risk of mortality is present in people with pre-diabetes. The result of this meta-analysis as well as information on prevalence, remission of pre-diabetes and transition to diabetes from an Australian cohort study, were used in the software program DisMod to calculate duration. RESULTS: From 2,578 articles identified, 11 studies met the inclusion criteria. The pooled relative risk of all-cause mortality was 1.26 (1.17-1.34) with no sign of heterogeneity between the studies. The average duration of pre-diabetes was 8.5 years in males aged 30+ and 10.3 years in females aged 30+. CONCLUSIONS: The duration of pre-diabetes in Australia is long enough to warrant a screening program. The finding is robust to sensitivity testing of very large variations in the epidemiological parameters. IMPLICATIONS: If the interventions following screening are shown to be cost-effective, a strong rationale for the implementation of a screening program exists.
OBJECTIVE: Interventions for individuals with pre-diabetes are efficacious, however, identification of people with pre-diabetes does not occur in Australia. This study aims to calculate the duration of pre-diabetes, in order to provide supporting evidence for a screening program. METHODS: We carried out a systematic review and random effects meta-analysis to identify if an increased risk of mortality is present in people with pre-diabetes. The result of this meta-analysis as well as information on prevalence, remission of pre-diabetes and transition to diabetes from an Australian cohort study, were used in the software program DisMod to calculate duration. RESULTS: From 2,578 articles identified, 11 studies met the inclusion criteria. The pooled relative risk of all-cause mortality was 1.26 (1.17-1.34) with no sign of heterogeneity between the studies. The average duration of pre-diabetes was 8.5 years in males aged 30+ and 10.3 years in females aged 30+. CONCLUSIONS: The duration of pre-diabetes in Australia is long enough to warrant a screening program. The finding is robust to sensitivity testing of very large variations in the epidemiological parameters. IMPLICATIONS: If the interventions following screening are shown to be cost-effective, a strong rationale for the implementation of a screening program exists.
Authors: Darin E Olson; Ming Zhu; Qi Long; Diana Barb; Jeehea S Haw; Mary K Rhee; Arun V Mohan; Phyllis I Watson-Williams; Sandra L Jackson; Anne M Tomolo; Peter W F Wilson; K M Venkat Narayan; Joseph Lipscomb; Lawrence S Phillips Journal: J Gen Intern Med Date: 2015-01-22 Impact factor: 5.128
Authors: Megan E Passey; Rupendra N Shrestha; Melanie Y Bertram; Deborah J Schofield; Theo Vos; Emily J Callander; Richard Percival; Simon J Kelly Journal: BMC Public Health Date: 2012-01-06 Impact factor: 3.295
Authors: Adedayo A Onitilo; Richard L Berg; Jessica M Engel; Ingrid Glurich; Rachel V Stankowski; Gail Williams; Suhail A Doi Journal: PLoS One Date: 2013-08-02 Impact factor: 3.240