Treating mild gestational diabetes may be cost-effective.

Taking a blood test during pregnancy

An economic evaluation has recently been evaluated by the Centre for Reviews and Dissemination (CRD).  They concluded that treatment for mild gestational diabetes is effective at improving maternal and neonatal outcomes.

Clinical question:

In women with mild gestational diabetes, are the benefits of treatment with diet or insulin worth the cost?

The analysis was undertaken from a US societal perspective.  It is not clear how “mild” gestational diabetes was defined.

The evidence

The analysis modelled the treatment of mild gestational diabetes using data on:

  • treatment effectivness from randomised trials
  • costs from published US sources
  • Quality-Adjusted Life-Years (QALYs) from published sources and from “conservative” estimates.

The analysis concludes:

The incremental cost per QALY gained with treatment over no treatment was $20,412.

Appraisal hints

Users of this research should consider:

  • The robustness of the evidence for treatment effectiveness, which relied on a small number of poorly-reported studies.
  • The perspective of the analysis was from a US payor and may not translate to other settings.
  • Some indirect costs were not included in the model.
  • The model was sensitive to treatment costs.


Read the full text of the the critical appraisal by the Centre for Reviews and Dissemination.

Ohno MS, Sparks TN, Cheng YW, Caughey AB.  Treating mild gestational diabetes mellitus: a cost-effectiveness analysis. Am J Obstet Gynecol. 2011 Sep;205(3):282.e1-7.

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I am an information scientist with an interest in making knowledge from systematic research more accessible to people who need it. This means you. I've been attempting this in the area of Evidence-Based Health Care since 1995. So far the results have been mixed. For some reason we expected busy clinicians to search databases and appraise papers instead of seeing patients. We also expected publishers to make the research freely available to the people who paid for it.. Ha! Hence The National Elf service.

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