Although lowering the threshold for a normal fasting plasma glucose would identify more adults at high risk for developing type 2 diabetes, intervention costs would increase, according to research published in Diabetes Care.
Xiaohui Zhuo, Ph.D., of the U.S. Centers for Disease Control and Prevention in Atlanta, and colleagues examined data from the National Health and Nutritional Examination Survey for individuals without diabetes in the United States, aged 45 years and older. The authors used a simulation model to assess the cost-effectiveness of using various fasting plasma glucose thresholds to identify adults at high risk for type 2 diabetes.
The researchers found that the cost per lifetime quality-adjusted life-year (QALY) gained increased as the fasting plasma glucose threshold was lowered ($30,100 at 115 mg/dL, $32,900 at 110 mg/dL, $42,300 at 105 mg/dL, $60,700 at 100 mg/dL, $81,800 at 95 mg/dL, and $115,800 at 90 mg/dL).
“Lowering the fasting plasma glucose threshold leads to a greater health benefit of diabetes prevention but reduces the cost-effectiveness,” the authors write. “Using the conventional benchmark of $50,000 per QALY, a threshold of 105 mg/dL or higher would be cost-effective.”