A comparison of cost per case detected of screening strategies for Type 2 diabetes and impaired glucose regulation: modelling study

Diabetes Res Clin Pract. 2012 Sep;97(3):505-13. doi: 10.1016/j.diabres.2012.03.009. Epub 2012 May 2.


Background: To determine a cost per case detected for different screening strategies for both Type 2 diabetes alone and in combination with impaired glucose regulation.

Methods: Bayesian framework modelling study using data from the ADDITION-Leicester screening study in UK multi-ethnic primary care setting. There were 5794 people aged 40-75 years (77.4% white European; 22.6% south Asian) without previously known diabetes. We compared 212 screening strategies including blood tests, a computer practice data score and a risk score, as part of a multi-stage process that all used an oral glucose tolerance test as the diagnostic test. Simulation models were created using sensitivity estimates for the expected cost per case.

Results: The estimated costs per case identified for the 18 most sensitive strategies varied from £457 to £1639 (€526-1886, for £1=€1.15) for diabetes and £148-913 (€170-1050) for both diabetes and impaired glucose regulation. The lowest costing diabetes strategies ranged from £457 to £523 (€526-601) involving a two-stage screening strategy, a non-invasive risk stratifying tool followed by a blood test, producing sensitivities ranging from 67.1 to 82.4%.

Conclusion: Screening a population using a non-invasive risk stratification tool followed by a screening blood test is the most cost-effective method of screening for diabetes and abnormal glucose tolerance.

Publication types

  • Comparative Study
  • Evaluation Study
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Aged
  • Decision Trees
  • Diabetes Mellitus, Type 2 / diagnosis*
  • Diabetes Mellitus, Type 2 / economics
  • Diagnostic Techniques, Endocrine / economics
  • Female
  • Glucose Intolerance / diagnosis*
  • Glucose Intolerance / economics
  • Humans
  • Male
  • Mass Screening / economics*
  • Mass Screening / methods
  • Middle Aged
  • Models, Biological
  • Models, Economic*
  • Sensitivity and Specificity
  • United Kingdom