Type 1 diabetes intervention clusters in resource-limited settings: a systematic review and economic evaluation
Authors' conclusion
Mobile health interventions show cost-effectiveness across income settings where supporting infrastructure exists. Intervention clusters provide greater health impact but require higher investment.
Study context
- Population
- People with T1D in resource-limited settings; studies from Jan 1, 2000 to Aug 31, 2024
- Participants
- 20,734 people89 studies
- Comparison
- T1D intervention clusters vs individual interventions
- Outcome
- Cost-effectiveness (QALYs and cost per QALY) of intervention clusters for T1D management
- Follow-up
- 10-year outcomes
Methodological detailsPRISMA 2020, Delphi process with 15 international experts, microsimulation model, WHO CHOICE methodology
- PRISMA 2020
- Delphi process with 15 international experts
- Microsimulation model
- WHO CHOICE methodology
Pooled result
As reported in the abstract
10 years
| Group | Value | Cost per quality-adjusted life-year (QALY) |
|---|---|---|
| Integrated care delivery | 264.6 QALYs (CI 198.5–330.7) per 1000 patients | $60 023 [45 018-78 029] |
| Public-private partnership | 281.5 QALYs (CI 211.1–351.9) | $60 624 [47 291-77 956] |
| Technology-enhanced self management | 238.5 QALYs (CI 178.9–298.1) | $158 360 [123 456-201 234] |
Value
Integrated care delivery264.6 QALYs (CI 198.5–330.7) per 1000 patients
Public-private partnership281.5 QALYs (CI 211.1–351.9)
Technology-enhanced self management238.5 QALYs (CI 178.9–298.1)
Cost per quality-adjusted life-year (QALY)
Integrated care delivery$60 023 [45 018-78 029]
Public-private partnership$60 624 [47 291-77 956]
Technology-enhanced self management$158 360 [123 456-201 234]
Further pooled results
- Mobile health cost-effectiveness
- INT$1788 · 95% CI 1342–2456 · per QALY
HbA1c reduction with individual interventions
- HbA1c reductions
- 0.32-0.89% (3.5-9.7 mmol/mol)
Original publication
Type 1 diabetes intervention clusters in resource-limited settings: a systematic review and economic evaluation. Lancet Diabetes Endocrinol. Published 15 May 2026. doi:10.
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