Effectiveness and cost-effectiveness of diet advice for patients with type 2 Diabetes Mellitus

Diabetes Mellitus type 2 is a common chronic disease where the glucose metabolism is disturbed mostly because of insulin resistance. One of the available treatments is diet advice provided by a dietitian. However, unknown is the cost-effectiveness of this diet advice. The objective of this review is to show to what extent diet advice is cost-effective for diabetic patients. A search strategy was performed in PubMed and 20 articles corresponded with the inclusion criteria. The most common result was a significant reduction of HbA1c and FPG levels. Also BMI, weight, waist circumference, BP and lipid profiles reduced significantly. Less frequently measured effects were significant improvements for disability days lost, complications, quality of life, work days lost and health utilization. Results stated that costs can be reduced by a decrease in complications, but that even savings can occur with risk reduction and this lead to fewer inpatient admissions, hospitalization rates, primary care and specialty visits. A relation is visible between T2DM and quality of life. Especially, smoking, body weight (BMI) and physical activity are risk factors who can contribute to the level of quality of life of a patient and diet advice could help to reduce these risk factors. It is not possible to quantify diet advice provided by a dietitian as cost-effective for patients with T2DM, but further research could be conducted to investigated this, even as the relation between T2DM and care chains and the optimal amount of hours of diet advice.