Cost Effective Analysis of Lifestyle Interventions versus standard treatment in Patients with Type 2 Diabetes: a Literature Review

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CHAPTER 2: LITERATURE REVIEW1

Theoretical Foundation3

Theories of Reasoned Action and Planned Behavior3

Theory of Reasoned Action4

Elements of the Theory of Reasoned Action5

Transtheoretical Model6

Diabetes Intervention Methods6

Standard Prevention Methods6

Lifestyle Interventions7

Physical Activity and Healthcare Management8

Researches on Cost Analysis10

Research 110

Research 210

Research 312

Research 414

Research 515

Costs of Diabetes and Costs of Complications17

Direct Costs of Diabetes18

Indirect Cost of Diabetes18

Cost of Standard Therapy18

Cost of Lifestyle Interventions19

Studies on the Effectiveness of Lifestyle Interventions20

Evidence Supporting Lifestyle Interventions for Diabetes20

Prevention20

Transferability and Uptake in Resource Poor Settings Requiring Critical Evaluation21

Lifestyle Intervention as the New the Diabetes Prevention Program22

Weight Loss and Diabetes Management22

Summary23

REFERENCES25

CHAPTER 2: LITERATURE REVIEW

Diabetes is a chronic disease that occurs when the pancreas does not produce enough insulin or when the body does not effectively use the insulin it produces. Insulin is a hormone that regulates blood sugar. The effect of uncontrolled diabetes is hyperglycemia (increased blood sugar), which eventually severely damage many organs and systems, especially the nerves and blood vessels. Every 7 seconds, one person dies of diabetes in the world, according to the International Diabetes Federation. That's more than AIDS and malaria combined. In 2010, 4 million people died from diabetes, or 6.8% of global mortality (Hatziandreu,1988). The bracket of most affected age is between 40 and 59 years. Diabetes type 1 (10% of cases) and type 2 diabetes (90%) are both characterized by genetic predisposition. More important than the genetic component, environmental factors (diet, physical activity) would be a major factor for the appearance of the disease. Diabetes, including that of type 2 is present in low and middle income countries where the total diagnosed cases are 70%. However, we consider that more than a third of people are unaware of their condition (Sherwood,2008).

According to Hamman,Edelstein, (2006) the most important part of diabetes treatment and prevention of late complications is diet. In the early stages of type 2 diabetes diet change can avoid medication. Just as in healthy people, its main purpose is to provide the right amount of nutrients and energy (particularly carbohydrates) and ensure proper hydration. Therefore, meals with diabetes need to be varied. The diabetic diet is dominated by foods that do not cause an excessive increase in blood glucose and allows keeping a healthy weight. This effect is achieved by appropriate selection of products, eating meals at regular times, but in smaller portions. Diabetic diet must be adapted to the needs of the individual patient in calories and nutrients, which is dependent on the age, body weight, led lifestyle and other conditions (such as pregnancy, breast feeding, accompanying diseases) and the additional risk factors (Blissmer,Riebe,2006). For people with diabetes, it is important to control the amount of carbohydrates. This heat exchanger corresponds to the quantity of the product, which contains 10 grams of carbohydrate assimilable by the organism. The patient should take care that these quantities do not change from day to day, although some modifications may be necessary depending on additional factors, such as the expected ...