Cost effectiveness of Diabetes Intervention in rural India

Diabetes is a global epidemic. Concerns about the burden of this disease are of increasing concern in developing countries. India has the highest number of diabetics in the world, with the disease impacting impoverished rural residents at an alarming rate. Estimates show that India has five-times the number of undiagnosed diabetics and diabetes-related deaths compared to the U.S. Programs are emerging to address the growing epidemic, but little is known about the cost-effectiveness of such programs. Sanjivani Health and Relief Committee, an Indian not profit organization, in partnership with a global project, Together on Diabetes, has established Project Diabetes to meet the devastating challenges of diabetes. They provide weekly diabetes screenings, education, and medication to impoverished residents in rural Gujarat villages.  Project Diabetes has been successful in increasing awareness of diabetes, educating residents about diabetes management, and improving diabetic health outcomes in the villages served.  We estimated the cost-effectiveness of this and similar diabetes programs in India using the Archimedes mathematical simulation model of disease progression, human physiology and health care utilization. Preliminary results indicate the program is cost-effective compared to usual practices in terms of reducing blood sugar levels below recommended thresholds. The success of Project Diabetes  suggests that mobile health education and medical care programs providing disease management for rural Indians can potentially improve health outcomes for the population they serve in a cost-effective and, thus, sustainable, manner.