Economic evaluation of type 2 diabetes prevention programmes: Markov model of low- and high-intensity lifestyle programmes and metformin in participants with different categories of intermediate hyperglycaemia

Background National guidance on preventing type 2 diabetes mellitus (T2DM) in the UK recommends low-intensity lifestyle interventions for individuals with intermediate categories of hyperglycaemia defined in terms of impaired fasting glucose (IFG) or ‘at-risk’ levels of HbA1c. In a recent systematic...

Celý popis

Uloženo v:

Podrobná bibliografie
Vydáno v:	BMC medicine Ročník 16; číslo 1; s. 16 - 12
Hlavní autoři:	Roberts, Samantha, Craig, Dawn, Adler, Amanda, McPherson, Klim, Greenhalgh, Trisha
Médium:	Journal Article
Jazyk:	angličtina
Vydáno:	London BioMed Central 30.01.2018 BioMed Central Ltd BMC
Témata:	Analysis Biomedicine Care and treatment Cost-Benefit Analysis Diabetes Mellitus, Type 2 - economics Diabetes Mellitus, Type 2 - prevention & control Diabetes prevention Dosage and administration Economic aspects Economic evaluation Female Health aspects Health care costs Humans Hyperglycemia Hyperglycemia - drug therapy Impaired fasting glucose Impaired glucose tolerance Intermediate hyperglycaemia Lifestyles Male management and treatment Markov processes Medicine Medicine & Public Health Metformin Metformin - economics Metformin - therapeutic use Prediabetes Prevention Research Article Risk factors Type 2 diabetes United Kingdom Impaired fasting glucose Economic evaluation HbA1c in at-risk range Prediabetes Intermediate hyperglycaemia Diabetes prevention Impaired glucose tolerance Cost-effective
ISSN:	1741-7015, 1741-7015
On-line přístup:	Získat plný text
Tagy:	Přidat tag Žádné tagy, Buďte první, kdo vytvoří štítek k tomuto záznamu!

Abstract	Background National guidance on preventing type 2 diabetes mellitus (T2DM) in the UK recommends low-intensity lifestyle interventions for individuals with intermediate categories of hyperglycaemia defined in terms of impaired fasting glucose (IFG) or ‘at-risk’ levels of HbA1c. In a recent systematic review of economic evaluations of such interventions, most studies had evaluated intensive trial-based lifestyle programmes in participants with impaired glucose tolerance (IGT). This study examines the costs and effects of different intensity lifestyle programmes and metformin in participants with different categories of intermediate hyperglycaemia. Methods We developed a decision tree and Markov model (50-year horizon) to compare four approaches, namely (1) a low-intensity lifestyle programme based on current NICE guidance, (2) a high-intensity lifestyle programme based on the US Diabetes Prevention Program, (3) metformin, and (4) no intervention, modelled for three different types of intermediate hyperglycaemia (IFG, IGT and HbA1c). A health system perspective was adopted and incremental analysis undertaken at an individual and population-wide level, taking England as a case study. Results Low-intensity lifestyle programmes were the most cost-effective (£44/QALY, £195/QALY and £186/QALY compared to no intervention in IGT, IFG and HbA1c, respectively). Intensive lifestyle interventions were also cost-effective compared to no intervention (£2775/QALY, £6820/QALY and £7376/QALY, respectively, in IGT, IFG and HbA1c). Metformin was cost-effective relative to no intervention (£5224/QALY, £6842/QALY and £372/QALY in IGT, IFG and HbA1c, respectively), but was only cost-effective relative to other treatments in participants identified with HbA1c. At a willingness-to-pay threshold of £20,000/QALY, low- and high-intensity lifestyle programmes were cost-effective 98%, 99% and 98% and 81%, 81% and 71% of the time in IGT, IFG and HbA1c, respectively. An England-wide programme for 50–59 year olds could reduce T2DM incidence by < 3.5% over 50 years and would cost 0.2–5.2% of the current diabetes budget for 2–9 years. Discussion This analysis suggests that current English national policy of low-intensity lifestyle programmes in participants with IFG or HbA1c will be cost-effective and have the most favourable budget impact, but will prevent only a fraction of cases of T2DM. Additional approaches to prevention need to be investigated urgently.
AbstractList	National guidance on preventing type 2 diabetes mellitus (T2DM) in the UK recommends low-intensity lifestyle interventions for individuals with intermediate categories of hyperglycaemia defined in terms of impaired fasting glucose (IFG) or 'at-risk' levels of HbA1c. In a recent systematic review of economic evaluations of such interventions, most studies had evaluated intensive trial-based lifestyle programmes in participants with impaired glucose tolerance (IGT). This study examines the costs and effects of different intensity lifestyle programmes and metformin in participants with different categories of intermediate hyperglycaemia. We developed a decision tree and Markov model (50-year horizon) to compare four approaches, namely (1) a low-intensity lifestyle programme based on current NICE guidance, (2) a high-intensity lifestyle programme based on the US Diabetes Prevention Program, (3) metformin, and (4) no intervention, modelled for three different types of intermediate hyperglycaemia (IFG, IGT and HbA1c). A health system perspective was adopted and incremental analysis undertaken at an individual and population-wide level, taking England as a case study. Low-intensity lifestyle programmes were the most cost-effective ([pounds sterling]44/QALY, [pounds sterling]195/QALY and [pounds sterling]186/QALY compared to no intervention in IGT, IFG and HbA1c, respectively). Intensive lifestyle interventions were also cost-effective compared to no intervention ([pounds sterling]2775/QALY, [pounds sterling]6820/QALY and [pounds sterling]7376/QALY, respectively, in IGT, IFG and HbA1c). Metformin was cost-effective relative to no intervention ([pounds sterling]5224/QALY, [pounds sterling]6842/QALY and [pounds sterling]372/QALY in IGT, IFG and HbA1c, respectively), but was only cost-effective relative to other treatments in participants identified with HbA1c. At a willingness-to-pay threshold of [pounds sterling]20,000/QALY, low- and high-intensity lifestyle programmes were cost-effective 98%, 99% and 98% and 81%, 81% and 71% of the time in IGT, IFG and HbA1c, respectively. An England-wide programme for 50-59 year olds could reduce T2DM incidence by < 3.5% over 50 years and would cost 0.2-5.2% of the current diabetes budget for 2-9 years. This analysis suggests that current English national policy of low-intensity lifestyle programmes in participants with IFG or HbA1c will be cost-effective and have the most favourable budget impact, but will prevent only a fraction of cases of T2DM. Additional approaches to prevention need to be investigated urgently. Background National guidance on preventing type 2 diabetes mellitus (T2DM) in the UK recommends low-intensity lifestyle interventions for individuals with intermediate categories of hyperglycaemia defined in terms of impaired fasting glucose (IFG) or 'at-risk' levels of HbA1c. In a recent systematic review of economic evaluations of such interventions, most studies had evaluated intensive trial-based lifestyle programmes in participants with impaired glucose tolerance (IGT). This study examines the costs and effects of different intensity lifestyle programmes and metformin in participants with different categories of intermediate hyperglycaemia. Methods We developed a decision tree and Markov model (50-year horizon) to compare four approaches, namely (1) a low-intensity lifestyle programme based on current NICE guidance, (2) a high-intensity lifestyle programme based on the US Diabetes Prevention Program, (3) metformin, and (4) no intervention, modelled for three different types of intermediate hyperglycaemia (IFG, IGT and HbA1c). A health system perspective was adopted and incremental analysis undertaken at an individual and population-wide level, taking England as a case study. Results Low-intensity lifestyle programmes were the most cost-effective ([pounds sterling]44/QALY, [pounds sterling]195/QALY and [pounds sterling]186/QALY compared to no intervention in IGT, IFG and HbA1c, respectively). Intensive lifestyle interventions were also cost-effective compared to no intervention ([pounds sterling]2775/QALY, [pounds sterling]6820/QALY and [pounds sterling]7376/QALY, respectively, in IGT, IFG and HbA1c). Metformin was cost-effective relative to no intervention ([pounds sterling]5224/QALY, [pounds sterling]6842/QALY and [pounds sterling]372/QALY in IGT, IFG and HbA1c, respectively), but was only cost-effective relative to other treatments in participants identified with HbA1c. At a willingness-to-pay threshold of [pounds sterling]20,000/QALY, low- and high-intensity lifestyle programmes were cost-effective 98%, 99% and 98% and 81%, 81% and 71% of the time in IGT, IFG and HbA1c, respectively. An England-wide programme for 50-59 year olds could reduce T2DM incidence by < 3.5% over 50 years and would cost 0.2-5.2% of the current diabetes budget for 2-9 years. Discussion This analysis suggests that current English national policy of low-intensity lifestyle programmes in participants with IFG or HbA1c will be cost-effective and have the most favourable budget impact, but will prevent only a fraction of cases of T2DM. Additional approaches to prevention need to be investigated urgently. Keywords: Diabetes prevention, Prediabetes, Intermediate hyperglycaemia, Economic evaluation, Impaired fasting glucose, Impaired glucose tolerance, HbA1c in at-risk range, Cost-effective National guidance on preventing type 2 diabetes mellitus (T2DM) in the UK recommends low-intensity lifestyle interventions for individuals with intermediate categories of hyperglycaemia defined in terms of impaired fasting glucose (IFG) or 'at-risk' levels of HbA1c. In a recent systematic review of economic evaluations of such interventions, most studies had evaluated intensive trial-based lifestyle programmes in participants with impaired glucose tolerance (IGT). This study examines the costs and effects of different intensity lifestyle programmes and metformin in participants with different categories of intermediate hyperglycaemia.BACKGROUNDNational guidance on preventing type 2 diabetes mellitus (T2DM) in the UK recommends low-intensity lifestyle interventions for individuals with intermediate categories of hyperglycaemia defined in terms of impaired fasting glucose (IFG) or 'at-risk' levels of HbA1c. In a recent systematic review of economic evaluations of such interventions, most studies had evaluated intensive trial-based lifestyle programmes in participants with impaired glucose tolerance (IGT). This study examines the costs and effects of different intensity lifestyle programmes and metformin in participants with different categories of intermediate hyperglycaemia.We developed a decision tree and Markov model (50-year horizon) to compare four approaches, namely (1) a low-intensity lifestyle programme based on current NICE guidance, (2) a high-intensity lifestyle programme based on the US Diabetes Prevention Program, (3) metformin, and (4) no intervention, modelled for three different types of intermediate hyperglycaemia (IFG, IGT and HbA1c). A health system perspective was adopted and incremental analysis undertaken at an individual and population-wide level, taking England as a case study.METHODSWe developed a decision tree and Markov model (50-year horizon) to compare four approaches, namely (1) a low-intensity lifestyle programme based on current NICE guidance, (2) a high-intensity lifestyle programme based on the US Diabetes Prevention Program, (3) metformin, and (4) no intervention, modelled for three different types of intermediate hyperglycaemia (IFG, IGT and HbA1c). A health system perspective was adopted and incremental analysis undertaken at an individual and population-wide level, taking England as a case study.Low-intensity lifestyle programmes were the most cost-effective (£44/QALY, £195/QALY and £186/QALY compared to no intervention in IGT, IFG and HbA1c, respectively). Intensive lifestyle interventions were also cost-effective compared to no intervention (£2775/QALY, £6820/QALY and £7376/QALY, respectively, in IGT, IFG and HbA1c). Metformin was cost-effective relative to no intervention (£5224/QALY, £6842/QALY and £372/QALY in IGT, IFG and HbA1c, respectively), but was only cost-effective relative to other treatments in participants identified with HbA1c. At a willingness-to-pay threshold of £20,000/QALY, low- and high-intensity lifestyle programmes were cost-effective 98%, 99% and 98% and 81%, 81% and 71% of the time in IGT, IFG and HbA1c, respectively. An England-wide programme for 50-59 year olds could reduce T2DM incidence by < 3.5% over 50 years and would cost 0.2-5.2% of the current diabetes budget for 2-9 years.RESULTSLow-intensity lifestyle programmes were the most cost-effective (£44/QALY, £195/QALY and £186/QALY compared to no intervention in IGT, IFG and HbA1c, respectively). Intensive lifestyle interventions were also cost-effective compared to no intervention (£2775/QALY, £6820/QALY and £7376/QALY, respectively, in IGT, IFG and HbA1c). Metformin was cost-effective relative to no intervention (£5224/QALY, £6842/QALY and £372/QALY in IGT, IFG and HbA1c, respectively), but was only cost-effective relative to other treatments in participants identified with HbA1c. At a willingness-to-pay threshold of £20,000/QALY, low- and high-intensity lifestyle programmes were cost-effective 98%, 99% and 98% and 81%, 81% and 71% of the time in IGT, IFG and HbA1c, respectively. An England-wide programme for 50-59 year olds could reduce T2DM incidence by < 3.5% over 50 years and would cost 0.2-5.2% of the current diabetes budget for 2-9 years.This analysis suggests that current English national policy of low-intensity lifestyle programmes in participants with IFG or HbA1c will be cost-effective and have the most favourable budget impact, but will prevent only a fraction of cases of T2DM. Additional approaches to prevention need to be investigated urgently.DISCUSSIONThis analysis suggests that current English national policy of low-intensity lifestyle programmes in participants with IFG or HbA1c will be cost-effective and have the most favourable budget impact, but will prevent only a fraction of cases of T2DM. Additional approaches to prevention need to be investigated urgently. Background National guidance on preventing type 2 diabetes mellitus (T2DM) in the UK recommends low-intensity lifestyle interventions for individuals with intermediate categories of hyperglycaemia defined in terms of impaired fasting glucose (IFG) or ‘at-risk’ levels of HbA1c. In a recent systematic review of economic evaluations of such interventions, most studies had evaluated intensive trial-based lifestyle programmes in participants with impaired glucose tolerance (IGT). This study examines the costs and effects of different intensity lifestyle programmes and metformin in participants with different categories of intermediate hyperglycaemia. Methods We developed a decision tree and Markov model (50-year horizon) to compare four approaches, namely (1) a low-intensity lifestyle programme based on current NICE guidance, (2) a high-intensity lifestyle programme based on the US Diabetes Prevention Program, (3) metformin, and (4) no intervention, modelled for three different types of intermediate hyperglycaemia (IFG, IGT and HbA1c). A health system perspective was adopted and incremental analysis undertaken at an individual and population-wide level, taking England as a case study. Results Low-intensity lifestyle programmes were the most cost-effective (£44/QALY, £195/QALY and £186/QALY compared to no intervention in IGT, IFG and HbA1c, respectively). Intensive lifestyle interventions were also cost-effective compared to no intervention (£2775/QALY, £6820/QALY and £7376/QALY, respectively, in IGT, IFG and HbA1c). Metformin was cost-effective relative to no intervention (£5224/QALY, £6842/QALY and £372/QALY in IGT, IFG and HbA1c, respectively), but was only cost-effective relative to other treatments in participants identified with HbA1c. At a willingness-to-pay threshold of £20,000/QALY, low- and high-intensity lifestyle programmes were cost-effective 98%, 99% and 98% and 81%, 81% and 71% of the time in IGT, IFG and HbA1c, respectively. An England-wide programme for 50–59 year olds could reduce T2DM incidence by < 3.5% over 50 years and would cost 0.2–5.2% of the current diabetes budget for 2–9 years. Discussion This analysis suggests that current English national policy of low-intensity lifestyle programmes in participants with IFG or HbA1c will be cost-effective and have the most favourable budget impact, but will prevent only a fraction of cases of T2DM. Additional approaches to prevention need to be investigated urgently. National guidance on preventing type 2 diabetes mellitus (T2DM) in the UK recommends low-intensity lifestyle interventions for individuals with intermediate categories of hyperglycaemia defined in terms of impaired fasting glucose (IFG) or 'at-risk' levels of HbA1c. In a recent systematic review of economic evaluations of such interventions, most studies had evaluated intensive trial-based lifestyle programmes in participants with impaired glucose tolerance (IGT). This study examines the costs and effects of different intensity lifestyle programmes and metformin in participants with different categories of intermediate hyperglycaemia. We developed a decision tree and Markov model (50-year horizon) to compare four approaches, namely (1) a low-intensity lifestyle programme based on current NICE guidance, (2) a high-intensity lifestyle programme based on the US Diabetes Prevention Program, (3) metformin, and (4) no intervention, modelled for three different types of intermediate hyperglycaemia (IFG, IGT and HbA1c). A health system perspective was adopted and incremental analysis undertaken at an individual and population-wide level, taking England as a case study. Low-intensity lifestyle programmes were the most cost-effective (£44/QALY, £195/QALY and £186/QALY compared to no intervention in IGT, IFG and HbA1c, respectively). Intensive lifestyle interventions were also cost-effective compared to no intervention (£2775/QALY, £6820/QALY and £7376/QALY, respectively, in IGT, IFG and HbA1c). Metformin was cost-effective relative to no intervention (£5224/QALY, £6842/QALY and £372/QALY in IGT, IFG and HbA1c, respectively), but was only cost-effective relative to other treatments in participants identified with HbA1c. At a willingness-to-pay threshold of £20,000/QALY, low- and high-intensity lifestyle programmes were cost-effective 98%, 99% and 98% and 81%, 81% and 71% of the time in IGT, IFG and HbA1c, respectively. An England-wide programme for 50-59 year olds could reduce T2DM incidence by < 3.5% over 50 years and would cost 0.2-5.2% of the current diabetes budget for 2-9 years. This analysis suggests that current English national policy of low-intensity lifestyle programmes in participants with IFG or HbA1c will be cost-effective and have the most favourable budget impact, but will prevent only a fraction of cases of T2DM. Additional approaches to prevention need to be investigated urgently. Abstract Background National guidance on preventing type 2 diabetes mellitus (T2DM) in the UK recommends low-intensity lifestyle interventions for individuals with intermediate categories of hyperglycaemia defined in terms of impaired fasting glucose (IFG) or ‘at-risk’ levels of HbA1c. In a recent systematic review of economic evaluations of such interventions, most studies had evaluated intensive trial-based lifestyle programmes in participants with impaired glucose tolerance (IGT). This study examines the costs and effects of different intensity lifestyle programmes and metformin in participants with different categories of intermediate hyperglycaemia. Methods We developed a decision tree and Markov model (50-year horizon) to compare four approaches, namely (1) a low-intensity lifestyle programme based on current NICE guidance, (2) a high-intensity lifestyle programme based on the US Diabetes Prevention Program, (3) metformin, and (4) no intervention, modelled for three different types of intermediate hyperglycaemia (IFG, IGT and HbA1c). A health system perspective was adopted and incremental analysis undertaken at an individual and population-wide level, taking England as a case study. Results Low-intensity lifestyle programmes were the most cost-effective (£44/QALY, £195/QALY and £186/QALY compared to no intervention in IGT, IFG and HbA1c, respectively). Intensive lifestyle interventions were also cost-effective compared to no intervention (£2775/QALY, £6820/QALY and £7376/QALY, respectively, in IGT, IFG and HbA1c). Metformin was cost-effective relative to no intervention (£5224/QALY, £6842/QALY and £372/QALY in IGT, IFG and HbA1c, respectively), but was only cost-effective relative to other treatments in participants identified with HbA1c. At a willingness-to-pay threshold of £20,000/QALY, low- and high-intensity lifestyle programmes were cost-effective 98%, 99% and 98% and 81%, 81% and 71% of the time in IGT, IFG and HbA1c, respectively. An England-wide programme for 50–59 year olds could reduce T2DM incidence by < 3.5% over 50 years and would cost 0.2–5.2% of the current diabetes budget for 2–9 years. Discussion This analysis suggests that current English national policy of low-intensity lifestyle programmes in participants with IFG or HbA1c will be cost-effective and have the most favourable budget impact, but will prevent only a fraction of cases of T2DM. Additional approaches to prevention need to be investigated urgently.
ArticleNumber	16
Audience	Academic
Author	Greenhalgh, Trisha McPherson, Klim Craig, Dawn Adler, Amanda Roberts, Samantha
Author_xml	– sequence: 1 givenname: Samantha surname: Roberts fullname: Roberts, Samantha email: samantha.roberts@gtc.ox.ac.uk organization: Nuffield Department of Primary Care Health Sciences, University of Oxford, Radcliffe Primary Care Building, Radcliffe Observatory Quarter – sequence: 2 givenname: Dawn surname: Craig fullname: Craig, Dawn organization: Institute of Health & Society, University of Newcastle – sequence: 3 givenname: Amanda surname: Adler fullname: Adler, Amanda organization: Addenbrooke’s Hospital – sequence: 4 givenname: Klim surname: McPherson fullname: McPherson, Klim organization: Nuffield Department of Primary Care Health Sciences, University of Oxford, Radcliffe Primary Care Building, Radcliffe Observatory Quarter – sequence: 5 givenname: Trisha surname: Greenhalgh fullname: Greenhalgh, Trisha organization: Nuffield Department of Primary Care Health Sciences, University of Oxford, Radcliffe Primary Care Building, Radcliffe Observatory Quarter
BackLink	https://www.ncbi.nlm.nih.gov/pubmed/29378576$$D View this record in MEDLINE/PubMed
BookMark	eNp9Ul9r1TAcLTJxf_QD-CIBQXzpbJq2aXwYjDF1MPFFn0Oa_tJmpklNcu-4H9NvZHrvHPeKjBYaknPO75z0nGZH1lnIste4OMe4bT4EXDLc5AWmecHaKq-eZSeYVjinBa6P9tbH2WkId0VR1pRWL7LjkhHa1rQ5yX5fS2fdpCWCtTArEbWzyCkUNzOgEvVadBAhoNnDGuz2dPZu8GKaIHxEX4X_6dZocj2YhWbcfY6E7dGohzHXNoINOm6Q0QpC3BjYY29xE0Tl_KQtSu8sfNRSz8LGgO51HNN8pcCnwUiKCIPzOvHSnEXZT5DsRUBj8uoHs5ECJi1eZs-VMAFePXzPsh-frr9ffclvv32-ubq8zWVTNDHHwDqo2xKriggMRNSkLgQjqm8Vq2vB-grXVdmUDWsq2Zekx7inUhDZScJ6TM6ym51u78Qdn72ehN9wJzTfbjg_8G0cA5zWpOsL2qkG2kphKprkQXXLz2ONUkXSuthpzasupZIpsBfmQPTwxOqRD27Na8pazGgSeP8g4N2vVbpqPukgwRhhwa0Cx4yRArckOTnL3u6gg0jWtFUuKcoFzi_rqiGMNZgk1Pl_UOnp0x2nyoDSaf-A8G6PMIIwcQzOrJbKhEPgm_2sjyH_djIB8A4gvQvBg3qE4IIvvee73vPUe770nleJQ__hSB23ZU62tXmSWe6YIU2xA3h-51bepuY8QfoDV0wboQ
CitedBy_id	crossref_primary_10_1080_14735784_2018_1543606 crossref_primary_10_1177_2047487319880041 crossref_primary_10_1016_S2213_8587_22_00186_3 crossref_primary_10_1186_s44247_025_00194_0 crossref_primary_10_1007_s00125_020_05224_2 crossref_primary_10_1080_03007995_2021_1955667 crossref_primary_10_1080_14737167_2020_1688146 crossref_primary_10_1002_ptr_6386 crossref_primary_10_1007_s40274_018_4690_z crossref_primary_10_1007_s00508_019_1450_4 crossref_primary_10_1186_s43094_025_00811_9 crossref_primary_10_1007_s41669_024_00487_6 crossref_primary_10_1007_s00125_024_06330_1 crossref_primary_10_1038_s41598_019_42574_3 crossref_primary_10_1007_s13300_020_00906_x crossref_primary_10_1111_dme_13867 crossref_primary_10_1007_s00392_025_02608_5 crossref_primary_10_1016_j_jval_2024_08_003 crossref_primary_10_1080_14737167_2021_1895755 crossref_primary_10_3390_endocrines3040062 crossref_primary_10_1111_obr_12821 crossref_primary_10_1007_s00508_022_02122_y crossref_primary_10_1136_bmjdrc_2024_004382 crossref_primary_10_1016_j_jdiacomp_2019_107444 crossref_primary_10_3390_ijerph16101677 crossref_primary_10_1155_2020_7410797 crossref_primary_10_1136_bmjopen_2019_033483 crossref_primary_10_1016_j_seps_2023_101552 crossref_primary_10_1007_s40258_024_00914_z crossref_primary_10_1007_s41669_021_00284_5
Cites_doi	10.1377/hlthaff.2011.1009 10.2337/dc10-0843 10.1186/s12955-014-0150-z 10.2337/dc16-S003 10.1136/bmjdrc-2015-000172 10.1136/bmjopen-2017-017184 10.1111/j.1464-5491.2012.03698.x 10.1056/NEJMoa012512 10.1016/j.diabres.2012.03.009 10.1007/s00125-005-0097-z 10.2337/diacare.20.4.537 10.1016/j.diabres.2010.06.008 10.1007/s40273-015-0327-2 10.1136/bmj.g4485 10.1186/s13012-015-0354-6 10.7326/M15-0452 10.2337/diacare.26.3.688 10.2337/dc14-0886 10.2337/dc13-1954 10.1097/MLR.0b013e31815b9772 10.1155/2016/2159890 10.3390/ijerph7083150 10.1136/bmj.i6538 10.1007/s00125-013-2902-4 10.2337/diacare.26.12.3230 10.1007/s00125-009-1443-3 10.7326/0003-4819-142-5-200503010-00007 10.1016/S2213-8587(15)00291-0
ContentType	Journal Article
Copyright	The Author(s). 2018 COPYRIGHT 2018 BioMed Central Ltd.
Copyright_xml	– notice: The Author(s). 2018 – notice: COPYRIGHT 2018 BioMed Central Ltd.
DBID	C6C AAYXX CITATION CGR CUY CVF ECM EIF NPM 7X8 5PM DOA
DOI	10.1186/s12916-017-0984-4
DatabaseName	Springer Nature OA Free Journals CrossRef Medline MEDLINE MEDLINE (Ovid) MEDLINE MEDLINE PubMed MEDLINE - Academic PubMed Central (Full Participant titles) DOAJ Directory of Open Access Journals
DatabaseTitle	CrossRef MEDLINE Medline Complete MEDLINE with Full Text PubMed MEDLINE (Ovid) MEDLINE - Academic
DatabaseTitleList	MEDLINE - Academic MEDLINE
Database_xml	– sequence: 1 dbid: DOA name: DOAJ Directory of Open Access Journals url: https://www.doaj.org/ sourceTypes: Open Website – sequence: 2 dbid: NPM name: PubMed url: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed sourceTypes: Index Database – sequence: 3 dbid: 7X8 name: MEDLINE - Academic url: https://search.proquest.com/medline sourceTypes: Aggregation Database
DeliveryMethod	fulltext_linktorsrc
Discipline	Medicine
EISSN	1741-7015
EndPage	12
ExternalDocumentID	oai_doaj_org_article_753bd07bf6e84f17a6c60fb291696ff0 PMC5798197 A546399613 29378576 10_1186_s12916_017_0984_4
Genre	Research Support, Non-U.S. Gov't Journal Article
GeographicLocations	United Kingdom
GeographicLocations_xml	– name: United Kingdom
GrantInformation_xml	– fundername: National Institute for Health Research grantid: Oxford Biomedical Research Centre funderid: https://dx.doi.org/10.13039/501100000272 – fundername: National Institute for Health Research grantid: Oxford Biomedical Research Centre – fundername: ; grantid: Oxford Biomedical Research Centre
GroupedDBID	--- 0R~ 23N 2WC 4.4 53G 5GY 5VS 6J9 6PF 7X7 88E 8FI 8FJ AAFWJ AAJSJ AASML AAWTL ABDBF ABUWG ACGFO ACGFS ACIHN ACPRK ACUHS ADBBV ADRAZ ADUKV AEAQA AENEX AFKRA AFPKN AFRAH AHBYD AHMBA AHYZX ALMA_UNASSIGNED_HOLDINGS AMKLP AMTXH AOIJS BAPOH BAWUL BCNDV BENPR BFQNJ BMC BPHCQ BVXVI C6C CCPQU CS3 DIK DU5 E3Z EAD EAP EAS EBD EBLON EBS EJD EMB EMK EMOBN ESX F5P FYUFA GROUPED_DOAJ GX1 H13 HMCUK HYE IAO IHR IHW INH INR ITC KQ8 M1P M48 MK0 M~E O5R O5S OK1 OVT P2P PGMZT PHGZM PHGZT PIMPY PJZUB PPXIY PQQKQ PROAC PSQYO PUEGO RBZ RNS ROL RPM RSV SMD SOJ SV3 TR2 TUS UKHRP WOQ WOW XSB AAYXX AFFHD CITATION -5E -5G -A0 -BR 3V. ACRMQ ADINQ ALIPV C24 CGR CUY CVF ECM EIF NPM 7X8 5PM
ID	FETCH-LOGICAL-c606t-1e9be5821f43a1e3a5350a93fd8f955a9d41542626964cd23d11d7ca3cbc39d13
IEDL.DBID	RSV
ISICitedReferencesCount	39
ISICitedReferencesURI	http://www.webofscience.com/api/gateway?GWVersion=2&SrcApp=Summon&SrcAuth=ProQuest&DestLinkType=CitingArticles&DestApp=WOS_CPL&KeyUT=000423747000001&url=https%3A%2F%2Fcvtisr.summon.serialssolutions.com%2F%23%21%2Fsearch%3Fho%3Df%26include.ft.matches%3Dt%26l%3Dnull%26q%3D
ISSN	1741-7015
IngestDate	Tue Oct 14 18:50:47 EDT 2025 Tue Nov 04 02:03:24 EST 2025 Sun Nov 09 14:21:38 EST 2025 Tue Nov 11 10:02:42 EST 2025 Tue Nov 04 17:44:29 EST 2025 Thu May 22 21:23:48 EDT 2025 Wed Feb 19 02:43:47 EST 2025 Tue Nov 18 21:40:38 EST 2025 Sat Nov 29 02:30:45 EST 2025 Sat Sep 06 07:29:17 EDT 2025
IsDoiOpenAccess	true
IsOpenAccess	true
IsPeerReviewed	true
IsScholarly	true
Issue	1
Keywords	Impaired fasting glucose Economic evaluation HbA1c in at-risk range Prediabetes Intermediate hyperglycaemia Diabetes prevention Impaired glucose tolerance Cost-effective
Language	English
License	Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
LinkModel	DirectLink
MergedId	FETCHMERGED-LOGICAL-c606t-1e9be5821f43a1e3a5350a93fd8f955a9d41542626964cd23d11d7ca3cbc39d13
Notes	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
OpenAccessLink	https://link.springer.com/10.1186/s12916-017-0984-4
PMID	29378576
PQID	1993018375
PQPubID	23479
PageCount	12
ParticipantIDs	doaj_primary_oai_doaj_org_article_753bd07bf6e84f17a6c60fb291696ff0 pubmedcentral_primary_oai_pubmedcentral_nih_gov_5798197 proquest_miscellaneous_1993018375 gale_infotracmisc_A546399613 gale_infotracacademiconefile_A546399613 gale_healthsolutions_A546399613 pubmed_primary_29378576 crossref_primary_10_1186_s12916_017_0984_4 crossref_citationtrail_10_1186_s12916_017_0984_4 springer_journals_10_1186_s12916_017_0984_4
PublicationCentury	2000
PublicationDate	2018-01-30
PublicationDateYYYYMMDD	2018-01-30
PublicationDate_xml	– month: 01 year: 2018 text: 2018-01-30 day: 30
PublicationDecade	2010
PublicationPlace	London
PublicationPlace_xml	– name: London – name: England
PublicationTitle	BMC medicine
PublicationTitleAbbrev	BMC Med
PublicationTitleAlternate	BMC Med
PublicationYear	2018
Publisher	BioMed Central BioMed Central Ltd BMC
Publisher_xml	– name: BioMed Central – name: BioMed Central Ltd – name: BMC
References	S Saha (984_CR17) 2010; 7 J Lindström (984_CR4) 2003; 26 NB Ashra (984_CR21) 2015 N Hex (984_CR37) 2012; 29 984_CR36 984_CR15 984_CR12 984_CR34 984_CR13 984_CR32 SA Mostafa (984_CR28) 2010; 90 P Vemer (984_CR41) 2016; 34 WH Herman (984_CR33) 2005; 142 International Diabetes Federation (984_CR1) 2015 A Ramachandran (984_CR5) 2006; 49 KI Radl (984_CR19) 2013; 10 EDE Group (984_CR30) 2003; 26 Diabetes Prevention Program Research Group (984_CR31) 2015; 3 Office of National Statistics (984_CR29) 2014 K Faerch (984_CR9) 2009; 52 The Community Guide (984_CR14) 2014 WC Knowler (984_CR2) 2002; 346 984_CR20 984_CR42 R Li (984_CR18) 2010; 33 World Health Organization (984_CR26) 2011 J Usher-Smith (984_CR25) 2017 XR Pan (984_CR3) 1997; 20 984_CR27 A Neumann (984_CR40) 2014; 12 JS Yudkin (984_CR11) 2014; 349 984_CR23 984_CR24 C Bachle (984_CR38) 2016; 4 National Institute of Clinical Excellence (984_CR22) 2013 R Kahn (984_CR7) 2014; 37 E Barry (984_CR8) 2017; 4 Diabetes UK (984_CR43) 2016 MK Ali (984_CR6) 2012; 1 D Morris (984_CR10) 2013; 56 K Alouki (984_CR16) 2016; 2016 K Khunti (984_CR35) 2012; 97 GA Nichols (984_CR39) 2008; 46 22537247 - Diabet Med. 2012 Jul;29(7):855-62 24652724 - Diabetes Care. 2014 Apr;37(4):943-9 18388843 - Med Care. 2008 Mar;46(3):287-92 15738451 - Ann Intern Med. 2005 Mar 1;142(5):323-32 26670418 - Implement Sci. 2015 Dec 15;10:172 20633944 - Diabetes Res Clin Pract. 2010 Oct;90(1):100-8 20948954 - Int J Environ Res Public Health. 2010 Aug;7(8):3150-95 12610023 - Diabetes Care. 2003 Mar;26(3):688-96 26167912 - Ann Intern Med. 2015 Sep 15;163(6):437-51 22232096 - Health Aff (Millwood). 2012 Jan;31(1):67-75 16391903 - Diabetologia. 2006 Feb;49(2):289-97 11832527 - N Engl J Med. 2002 Feb 7;346(6):393-403 23584433 - Diabetologia. 2013 Jul;56(7):1489-93 9096977 - Diabetes Care. 1997 Apr;20(4):537-44 25342083 - Health Qual Life Outcomes. 2014 Oct 24;12:150 20668156 - Diabetes Care. 2010 Aug;33(8):1872-94 27252871 - BMJ Open Diabetes Res Care. 2016 May 25;4(1):e000172 26696680 - Diabetes Care. 2016 Jan;39 Suppl 1:S4-5 19590846 - Diabetologia. 2009 Sep;52(9):1714-23 25028385 - BMJ. 2014 Jul 15;349:g4485 28052845 - BMJ. 2017 Jan 4;356:i6538 25336746 - Diabetes Care. 2015 Jan;38(1):51-8 26377054 - Lancet Diabetes Endocrinol. 2015 Nov;3(11):866-75 14633807 - Diabetes Care. 2003 Dec;26(12):3230-6 29146638 - BMJ Open. 2017 Nov 15;7(11):e017184 26885527 - J Diabetes Res. 2016;2016:2159890 22554999 - Diabetes Res Clin Pract. 2012 Sep;97(3):505-13 26660529 - Pharmacoeconomics. 2016 Apr;34(4):349-61
References_xml	– volume: 1 start-page: 67 issue: 31 year: 2012 ident: 984_CR6 publication-title: Health Aff doi: 10.1377/hlthaff.2011.1009 – volume-title: Diabetes prevention and control: combined diet and physical activity promotion programs to prevent type 2 diabetes among people at increased risk year: 2014 ident: 984_CR14 – volume: 33 start-page: 1872 issue: 8 year: 2010 ident: 984_CR18 publication-title: Diabetes Care doi: 10.2337/dc10-0843 – volume-title: Guide to the Technology Appraisal Process year: 2013 ident: 984_CR22 – ident: 984_CR34 – ident: 984_CR36 – ident: 984_CR13 – volume: 12 start-page: 150 year: 2014 ident: 984_CR40 publication-title: Health Qual Life Outcomes doi: 10.1186/s12955-014-0150-z – ident: 984_CR32 – ident: 984_CR27 doi: 10.2337/dc16-S003 – volume: 4 start-page: e000172 issue: 1 year: 2016 ident: 984_CR38 publication-title: BMJ Open Diabetes Res Care doi: 10.1136/bmjdrc-2015-000172 – ident: 984_CR15 doi: 10.1136/bmjopen-2017-017184 – volume: 29 start-page: 855 year: 2012 ident: 984_CR37 publication-title: Diabet Med doi: 10.1111/j.1464-5491.2012.03698.x – volume-title: Deaths registered in England and Wales year: 2014 ident: 984_CR29 – volume: 346 start-page: 393 year: 2002 ident: 984_CR2 publication-title: N Engl J Med doi: 10.1056/NEJMoa012512 – volume: 97 start-page: 505 issue: 3 year: 2012 ident: 984_CR35 publication-title: Diabetes Res Clin Pract doi: 10.1016/j.diabres.2012.03.009 – volume: 10 start-page: 2 year: 2013 ident: 984_CR19 publication-title: Epidemiol Biostat Public Health – volume: 49 start-page: 289 year: 2006 ident: 984_CR5 publication-title: Diabetologia doi: 10.1007/s00125-005-0097-z – volume: 20 start-page: 537 year: 1997 ident: 984_CR3 publication-title: Diabetes Care doi: 10.2337/diacare.20.4.537 – volume: 90 start-page: 100 issue: 1 year: 2010 ident: 984_CR28 publication-title: Diabetes Res Clin Pract doi: 10.1016/j.diabres.2010.06.008 – volume: 34 start-page: 349 year: 2016 ident: 984_CR41 publication-title: Pharmacoeconomics doi: 10.1007/s40273-015-0327-2 – volume: 349 start-page: g4485 year: 2014 ident: 984_CR11 publication-title: BMJ doi: 10.1136/bmj.g4485 – ident: 984_CR24 doi: 10.1186/s13012-015-0354-6 – ident: 984_CR20 doi: 10.7326/M15-0452 – volume: 26 start-page: 688 issue: 3 year: 2003 ident: 984_CR30 publication-title: Diabetes Care doi: 10.2337/diacare.26.3.688 – ident: 984_CR12 doi: 10.2337/dc14-0886 – volume: 37 start-page: 943 issue: 4 year: 2014 ident: 984_CR7 publication-title: Diabetes Care doi: 10.2337/dc13-1954 – volume: 46 start-page: 287 issue: 3 year: 2008 ident: 984_CR39 publication-title: Med Care doi: 10.1097/MLR.0b013e31815b9772 – volume-title: International Diabetes Federation Diabetes Atlas year: 2015 ident: 984_CR1 – volume-title: Diabetes Prevalence 2016 year: 2016 ident: 984_CR43 – volume-title: Use of glycated haemoglobin (HbA1c) in the diagnosis of diabetes mellitus year: 2011 ident: 984_CR26 – volume: 2016 start-page: 2159890 year: 2016 ident: 984_CR16 publication-title: J Diabetes Res doi: 10.1155/2016/2159890 – volume: 7 start-page: 3150 issue: 8 year: 2010 ident: 984_CR17 publication-title: Int J Environ Res Health doi: 10.3390/ijerph7083150 – volume-title: A systematic review and meta-analysis assessing the effectiveness of pragmatic lifestyle interventions for the prevention of type 2 diabetes mellitus in routine practice year: 2015 ident: 984_CR21 – volume: 4 start-page: i6538 issue: 356 year: 2017 ident: 984_CR8 publication-title: BMJ doi: 10.1136/bmj.i6538 – volume-title: NHS Health Check Programme rapid evidence synthesis year: 2017 ident: 984_CR25 – volume: 56 start-page: 1489 issue: 7 year: 2013 ident: 984_CR10 publication-title: Diabetologia doi: 10.1007/s00125-013-2902-4 – volume: 26 start-page: 3230 year: 2003 ident: 984_CR4 publication-title: Diabetes Care doi: 10.2337/diacare.26.12.3230 – volume: 52 start-page: 1714 year: 2009 ident: 984_CR9 publication-title: Diabetologica doi: 10.1007/s00125-009-1443-3 – volume: 142 start-page: 323 year: 2005 ident: 984_CR33 publication-title: Ann Intern Med doi: 10.7326/0003-4819-142-5-200503010-00007 – ident: 984_CR42 – ident: 984_CR23 – volume: 3 start-page: 866 issue: 11 year: 2015 ident: 984_CR31 publication-title: Lancet Diabetes Endocrinol doi: 10.1016/S2213-8587(15)00291-0 – reference: 11832527 - N Engl J Med. 2002 Feb 7;346(6):393-403 – reference: 26885527 - J Diabetes Res. 2016;2016:2159890 – reference: 14633807 - Diabetes Care. 2003 Dec;26(12):3230-6 – reference: 20948954 - Int J Environ Res Public Health. 2010 Aug;7(8):3150-95 – reference: 26167912 - Ann Intern Med. 2015 Sep 15;163(6):437-51 – reference: 29146638 - BMJ Open. 2017 Nov 15;7(11):e017184 – reference: 12610023 - Diabetes Care. 2003 Mar;26(3):688-96 – reference: 9096977 - Diabetes Care. 1997 Apr;20(4):537-44 – reference: 25342083 - Health Qual Life Outcomes. 2014 Oct 24;12:150 – reference: 19590846 - Diabetologia. 2009 Sep;52(9):1714-23 – reference: 27252871 - BMJ Open Diabetes Res Care. 2016 May 25;4(1):e000172 – reference: 18388843 - Med Care. 2008 Mar;46(3):287-92 – reference: 28052845 - BMJ. 2017 Jan 4;356:i6538 – reference: 25336746 - Diabetes Care. 2015 Jan;38(1):51-8 – reference: 26660529 - Pharmacoeconomics. 2016 Apr;34(4):349-61 – reference: 22554999 - Diabetes Res Clin Pract. 2012 Sep;97(3):505-13 – reference: 23584433 - Diabetologia. 2013 Jul;56(7):1489-93 – reference: 20633944 - Diabetes Res Clin Pract. 2010 Oct;90(1):100-8 – reference: 24652724 - Diabetes Care. 2014 Apr;37(4):943-9 – reference: 26670418 - Implement Sci. 2015 Dec 15;10:172 – reference: 20668156 - Diabetes Care. 2010 Aug;33(8):1872-94 – reference: 22232096 - Health Aff (Millwood). 2012 Jan;31(1):67-75 – reference: 15738451 - Ann Intern Med. 2005 Mar 1;142(5):323-32 – reference: 16391903 - Diabetologia. 2006 Feb;49(2):289-97 – reference: 25028385 - BMJ. 2014 Jul 15;349:g4485 – reference: 26696680 - Diabetes Care. 2016 Jan;39 Suppl 1:S4-5 – reference: 22537247 - Diabet Med. 2012 Jul;29(7):855-62 – reference: 26377054 - Lancet Diabetes Endocrinol. 2015 Nov;3(11):866-75
SSID	ssj0025774
Score	2.3853328
Snippet	Background National guidance on preventing type 2 diabetes mellitus (T2DM) in the UK recommends low-intensity lifestyle interventions for individuals with... National guidance on preventing type 2 diabetes mellitus (T2DM) in the UK recommends low-intensity lifestyle interventions for individuals with intermediate... Background National guidance on preventing type 2 diabetes mellitus (T2DM) in the UK recommends low-intensity lifestyle interventions for individuals with... Abstract Background National guidance on preventing type 2 diabetes mellitus (T2DM) in the UK recommends low-intensity lifestyle interventions for individuals...
SourceID	doaj pubmedcentral proquest gale pubmed crossref springer
SourceType	Open Website Open Access Repository Aggregation Database Index Database Enrichment Source Publisher
StartPage	16
SubjectTerms	Analysis Biomedicine Care and treatment Cost-Benefit Analysis Diabetes Mellitus, Type 2 - economics Diabetes Mellitus, Type 2 - prevention & control Diabetes prevention Dosage and administration Economic aspects Economic evaluation Female Health aspects Health care costs Humans Hyperglycemia Hyperglycemia - drug therapy Impaired fasting glucose Impaired glucose tolerance Intermediate hyperglycaemia Lifestyles Male management and treatment Markov processes Medicine Medicine & Public Health Metformin Metformin - economics Metformin - therapeutic use Prediabetes Prevention Research Article Risk factors Type 2 diabetes
SummonAdditionalLinks	– databaseName: DOAJ Directory of Open Access Journals dbid: DOA link: http://cvtisr.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwrV1fi9QwEA9yiPgi_rfnqREEQSnXNGnT-HaKhy8ePijcW0jT5G5ht122vZP9mH4jZ9J0vZ6oL8I-NZNukplOZpKZ3xDyijnvrRU2zbkyqVCcgR70YMj5hnNVZ8o0VSg2IU9OqtNT9eVKqS-MCRvhgceFOwRzum4yWfvSVcIzaUpbZr7OwaxRpffBW8-kmpyp6GoVYNXEO0xWlYc9Q_oUNXKmKpGK2S4UwPp_V8lX9qTr8ZLXLk3DXnR8l9yJRiQ9Ggd_j9xw7X1y63O8Jn9AfkzpxvQXmDftPMXzVprT6byVriN-E7TGOK2V699RzN_pLmkokoPdlt33lJq2oYhtnC7GoPdhS5cLDxPYLt2V3oFu5Qa0hRcthd_axMjtdugpHvvSqSjLQDEc66xDbx3_B9-8Caksg6PnMNbN2XJrjVstzEPy7fjj1w-f0li7IQX2lEPKnKodJuF6wQ1z3BS8yIzivqm8KgqjGrAcEA0fuChsk_OGsUZaw21tuWoYf0T22q51TwgVpVDScu9zb4TJnVK5rFmlRFU2RV6ahGQTL7WNwOZYX2Opg4NTlXpkvwb2a2S_Fgl5s-uyHlE9_kb8HgVkR4iA3OEBiKmOYqr_JaYJeYHipcfs1p1a0UdYjgB8TsYT8jpQoGKB4VsT8yNgERCia0Z5MKMEhWBnzS8nEdbYhFF0resueo3BmhnocFkk5PEo0rtZgdknK3A-EyJnwj6b9rylXZwHPPJCKrArZULeTp-Fjoqw__Oq7v-PVX1KboMBi9GYKc8OyN6wuXDPyE17OSz6zfOgEn4CvbxpRA priority: 102 providerName: Directory of Open Access Journals
Title	Economic evaluation of type 2 diabetes prevention programmes: Markov model of low- and high-intensity lifestyle programmes and metformin in participants with different categories of intermediate hyperglycaemia
URI	https://link.springer.com/article/10.1186/s12916-017-0984-4 https://www.ncbi.nlm.nih.gov/pubmed/29378576 https://www.proquest.com/docview/1993018375 https://pubmed.ncbi.nlm.nih.gov/PMC5798197 https://doaj.org/article/753bd07bf6e84f17a6c60fb291696ff0
Volume	16
WOSCitedRecordID	wos000423747000001&url=https%3A%2F%2Fcvtisr.summon.serialssolutions.com%2F%23%21%2Fsearch%3Fho%3Df%26include.ft.matches%3Dt%26l%3Dnull%26q%3D
hasFullText	1
inHoldings	1
isFullTextHit
isPrint
journalDatabaseRights	– providerCode: PRVADU databaseName: BioMedCentral customDbUrl: eissn: 1741-7015 dateEnd: 99991231 omitProxy: false ssIdentifier: ssj0025774 issn: 1741-7015 databaseCode: RBZ dateStart: 20030101 isFulltext: true titleUrlDefault: https://www.biomedcentral.com/search/ providerName: BioMedCentral – providerCode: PRVAON databaseName: DOAJ Directory of Open Access Journals customDbUrl: eissn: 1741-7015 dateEnd: 99991231 omitProxy: false ssIdentifier: ssj0025774 issn: 1741-7015 databaseCode: DOA dateStart: 20030101 isFulltext: true titleUrlDefault: https://www.doaj.org/ providerName: Directory of Open Access Journals – providerCode: PRVHPJ databaseName: ROAD: Directory of Open Access Scholarly Resources customDbUrl: eissn: 1741-7015 dateEnd: 99991231 omitProxy: false ssIdentifier: ssj0025774 issn: 1741-7015 databaseCode: M~E dateStart: 20030101 isFulltext: true titleUrlDefault: https://road.issn.org providerName: ISSN International Centre – providerCode: PRVPQU databaseName: Health & Medical Collection customDbUrl: eissn: 1741-7015 dateEnd: 99991231 omitProxy: false ssIdentifier: ssj0025774 issn: 1741-7015 databaseCode: 7X7 dateStart: 20090101 isFulltext: true titleUrlDefault: https://search.proquest.com/healthcomplete providerName: ProQuest – providerCode: PRVPQU databaseName: ProQuest Central customDbUrl: eissn: 1741-7015 dateEnd: 99991231 omitProxy: false ssIdentifier: ssj0025774 issn: 1741-7015 databaseCode: BENPR dateStart: 20090101 isFulltext: true titleUrlDefault: https://www.proquest.com/central providerName: ProQuest – providerCode: PRVPQU databaseName: ProQuest Publicly Available Content Database customDbUrl: eissn: 1741-7015 dateEnd: 99991231 omitProxy: false ssIdentifier: ssj0025774 issn: 1741-7015 databaseCode: PIMPY dateStart: 20090101 isFulltext: true titleUrlDefault: http://search.proquest.com/publiccontent providerName: ProQuest – providerCode: PRVAVX databaseName: SpringerLINK Contemporary 1997-Present customDbUrl: eissn: 1741-7015 dateEnd: 99991231 omitProxy: false ssIdentifier: ssj0025774 issn: 1741-7015 databaseCode: RSV dateStart: 20031201 isFulltext: true titleUrlDefault: https://link.springer.com/search?facet-content-type=%22Journal%22 providerName: Springer Nature
link	http://cvtisr.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwnV1ba9swFBZrO8Zedr946zINBoMNU9uSLWtv7WjZHhpCd6F7ErIspYbEDrHbkZ-5fzQdRc7q7gIbmICjI9u6nYt0zncQehlrY5SiKkwIlyHlJLZ80FhFzpSE8CLissxdsgk2Huenp3zi47jb3tu9P5J0nNot6zzba61kisH6ZWHEcxrSLbRjpV0O-RpOPn7ZWFmpVWj88eVvqw0EkMPp_5UbXxJHV10lr5yXOjF0dPu_GnAH3fJaJ95fT5O76Jqu76Ebx_5c_T763scn45_o37gxGDZocYL7DVq88IBPttQ7ds11-xZDwE9zgV1WHag2a76FWNYlBjDksFp7yXcrPKuMbfZqpi_VdnRz3YHyXNXYXgvpXb3rrsWwT4z7LC4dBv-taQPmPbwHnrx0sS-dxmf2W5fT2UpJPa_kA_T56PDTu_ehT_YQKmtDdWGseaEhatdQImNNZErSSHJiytzwNJW8tKoGwOdnPKOqTEgZxyVTkqhCEV7G5CHarptaP0aYZpQzRYxJjKQy0ZwnrIhzTvOsTJNMBijqZ4BQHgkdEnLMhLOI8kysh0rYoRIwVIIG6PWmymINA_I34gOYVhtCQPB2fzTLqfAMQVgzsSgjVphM59TETGa2H0wBj-KZMVGAnsOkFOtw2A0fEvuQv8AaqTEJ0CtHAZzIfr6SPqDCdgJgeg0odweUloOoQfGLfuILKAK3u1o3560A787IMn2WBujReiFsWmX1RJZbazVAbLBEBs0eltTVmQMwTxm3iigL0Jt-oQjPOds_9-qTf6J-im5a1Rb8NEMS7aLtbnmun6Hr6qKr2uUIbbFT5n7zEdo5OBxPTkZuN8beTT4cT76OHE_5AU0Bcsw
linkProvider	Springer Nature
linkToHtml	http://cvtisr.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwnV1Lb9QwELagIMqFNyVQqJGQkEARSezEMbeCqIpoVwgK6s1yHHsbaTdZbdKi_Zn8IzyOszTlIYG0p3icje3xPOyZbxB6FmtjlKIqTAiXIeUktnLQWEPOlITwIuKyzF2xCTaZ5MfH_KPP426HaPfhStJJaret8-xVazVTDN4vCyOe05BeRleoVVgAmP_p89e1l5Vag8ZfX_6220gBOZz-X6XxOXV0MVTywn2pU0N7N_9rALfQDW914t2eTW6jS7q-g64d-nv1u-j7kJ-Mf6J_48ZgOKDFCR4OaPHCAz7ZVh_YNdftawwJP80ZdlV1oNus-RZiWZcYwJDDqo-S71Z4Vhk77NVMn-vt6Oa6A-O5qrH9LaQP9a67FsM5MR6quHQY4remDbj38D_w5qXLfek0PrHfupzOVkrqeSXvoS97747e7oe-2EOorA_VhbHmhYasXUOJjDWRKUkjyYkpc8PTVPLSmhoAn5_xjKoyIWUcl0xJogpFeBmT-2ijbmr9AGGaUc4UMSYxkspEc56wIs45zbMyTTIZoGjgAKE8EjoU5JgJ5xHlmeiXStilErBUggboxbrLoocB-RvxG2CrNSEgeLsHzXIqvEAQ1k0syogVJtM5NTGTmZ0HU8CreGZMFKAdYErRp8Ou5ZDYhfoF1kmNSYCeOwqQRPbzlfQJFXYSANNrRLk9orQSRI2anw6ML6AJwu5q3Zy2AqI7Iyv0WRqgrX4jrEdl7USWW281QGy0RUbDHrfU1YkDME8Zt4YoC9DLYaMILznbP8_qw3-i3kGb-0eHB-Lg_eTDI3TdmrkQsxmSaBttdMtT_RhdVWdd1S6fOOnxA5b6b6A
linkToPdf	http://cvtisr.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwpV1Zb9QwELagoIqXckOgUCMhIYGiJrETx7yVYwUCVpU41DfL8bGNtJusNmmr_Zn8IzyJszTlkBDSPsXjbHzMZc98g9DT2FirFFVhQrgMKSexk4PWGXJWE8KLiEudd8Um2HSaHx3xQ1_ntBmi3YcryT6nAVCaqnZ_qW3P4nm23zgtFYMnzMKI5zSkl9EVCnH04K5__rbxuFJn3PirzN92GymjDrP_V8l8TjVdDJu8cHfaqaTJ9f8ezA20461RfNBvn5vokqluoe1P_r79Nvo-5C3jn6jguLYYDm5xgoeDW7z0QFCu1Qd8LUzzEkMiUH2Ku2o70G1en4VYVhoDSHJY9tHz7RrPS-umYD0353p3dAvTglFdVtj9ltKHgFdtg-H8GA_VXVoMcV2zGtx--B9486rLiWkNPnbfuprN10qaRSnvoK-Tt19evwt9EYhQOd-qDWPDCwPZvJYSGRsiU5JGkhOrc8vTVHLtTBCA1c94RpVOiI5jzZQkqlCE65jcRVtVXZn7CNOMcqaItYmVVCaG84QVcc5pnuk0yWSAomE3COUR0qFQx1x0nlKeiX6phFsqAUslaICeb7ose3iQvxG_gi22IQRk7-5BvZoJLyiEcx8LHbHCZianNmYyc_NgC3gVz6yNArQHG1T0abIb-SQOoK6Bc15jEqBnHQVIKPf5SvpECzcJgPU1otwdUTrJokbNTwYmENAE4XiVqU8aAVGfkVMGLA3QvZ4pNqNy9iPLnRcbIDZil9Gwxy1VedwBm6eMOwOVBejFwDTCS9Tmz7P64J-o99D24ZuJ-Ph--uEhuuasXwjlDEm0i7ba1Yl5hK6q07ZsVo87QfIDHtd4hA
openUrl	ctx_ver=Z39.88-2004&ctx_enc=info%3Aofi%2Fenc%3AUTF-8&rfr_id=info%3Asid%2Fsummon.serialssolutions.com&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.atitle=Economic+evaluation+of+type+2+diabetes+prevention+programmes%3A+Markov+model+of+low-+and+high-intensity+lifestyle+programmes+and+metformin+in+participants+with+different+categories+of+intermediate+hyperglycaemia&rft.jtitle=BMC+medicine&rft.au=Roberts%2C+Samantha&rft.au=Craig%2C+Dawn&rft.au=Adler%2C+Amanda&rft.au=McPherson%2C+Klim&rft.date=2018-01-30&rft.pub=BioMed+Central&rft.eissn=1741-7015&rft.volume=16&rft.issue=1&rft_id=info:doi/10.1186%2Fs12916-017-0984-4&rft.externalDocID=10_1186_s12916_017_0984_4
thumbnail_l	http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/lc.gif&issn=1741-7015&client=summon
thumbnail_m	http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/mc.gif&issn=1741-7015&client=summon
thumbnail_s	http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/sc.gif&issn=1741-7015&client=summon