Charles Perkins Centre, School of Life and Environmental Sciences, The University of Sydney, Sydney, NSW, Australia.
Boden Collaboration, The University of Sydney, Sydney, NSW, Australia.
J Hum Nutr Diet. 2021 Feb;34(1):81-93. doi: 10.1111/jhn.12821. Epub 2020 Oct 14.
The management of diabetes costs in excess of $1.3 trillion per annum worldwide. Diet is central to the management of type 2 diabetes. It is not known whether dietetic intervention is cost effective. This scoping review aimed to map the existing literature concerning the cost effectiveness of medical nutrition therapy provided by dietitians for people with type 2 diabetes.
Thirteen scientific databases, including MEDLINE, EMBASE and CINAHL, as well as multiple official websites, were searched to source peer-reviewed articles, reports, guidelines, dissertations and other grey literature published from 2008 to present. Eligible articles had to have assessed and reported the cost effectiveness of dietetic intervention for adults with type 2 diabetes in developed countries. Experimental, quasi-experimental, observational and qualitative studies were considered.
Of 2387 abstracts assessed for eligibility, four studies combining 22 765 adults with type 2 diabetes were included. Dietetic intervention was shown to be cost-effective in terms of diabetes-related healthcare costs and hospital charges, at the same time as also reducing the risk of cumulative days at work lost to less than half and the risk of disability 'sick' days at work to less than one-seventh.
The findings highlight the importance of advocacy for medical nutrition therapy for people with type 2 diabetes, with respect to alleviating the great global economic burden from this condition. Further studies are warranted to elucidate the factors that mediate and moderate cost effectiveness and to allow for the generalisation of the findings.
全球范围内，糖尿病的管理成本超过每年 1.3 万亿美元。饮食是 2 型糖尿病管理的核心。目前尚不清楚饮食干预是否具有成本效益。本范围综述旨在绘制现有文献，以了解营养师为 2 型糖尿病患者提供的医学营养治疗的成本效益。
从 2008 年至今，13 个科学数据库（包括 MEDLINE、EMBASE 和 CINAHL）以及多个官方网站被搜索，以获取同行评审的文章、报告、指南、论文和其他灰色文献。合格的文章必须评估和报告营养师对发达国家 2 型糖尿病成人的饮食干预的成本效益。实验、准实验、观察性和定性研究都被考虑在内。
在评估合格性的 2387 篇摘要中，有 4 项研究共纳入 22765 名 2 型糖尿病成年人，饮食干预在糖尿病相关医疗保健成本和住院费用方面具有成本效益，同时也将累计因病缺勤天数降低到不到一半，因病缺勤工作天数降低到不到七分之一。
这些发现强调了倡导 2 型糖尿病患者进行医学营养治疗的重要性，这有助于减轻这种疾病给全球经济带来的巨大负担。需要进一步研究来阐明影响成本效益的因素，并使研究结果具有普遍性。
