Clinical efficacy and cost-effectiveness analysis of treatment at the Diabetes Remission clinic at Talat Bueng Subdistrict Health Promotion Hospital

Abstract

Introduction: Type 2 diabetes mellitus is a major public health challenge. Although intensive lifestyle modification can achieve diabetes remission, empirical evidence regarding its clinical efficacy and cost-effectiveness in primary care settings remains limited.

Objective: To compare reduction levels of HbA1c between patients receiving standard chronic disease care with patients undergoing treatment at a specialized Diabetes Remission clinic, taking into consideration the costs, and cost-effectiveness of both treatments.

Methods: This retrospective observational medical record review was conducted from March to April 2026 at the Talat Bueng Subdistrict Health Promotion Hospital. 60 newly diagnosed T2DM patients were divided into two groups (n=30 each) consisting of a comparison group and a study group. The comparison group (diagnosed between January 2019 and June 2023) received conventional chronic care, while the study group (diagnosed between July 2023 and December 2024) was treated following a Diabetes Remission clinic model featuring small groups focused on lifestyle modification, de-prescribing and supported by community health volunteers. Therapeutic outcomes were compared at post-diagnosis 1-year intervals. Data were analyzed using descriptive statistics, inferential statistics, and economic evaluation.

Results: The study group showed a significantly greater mean in HbA1c point reductions (3.30±3.28 percentage points) when measured with the comparison group’s results (1.42±2.32 percentage points; p = 0.013). In the study group, 20 percent of patients achieved diabetes remission, whereas no remissions were observed in the comparison group. Furthermore, the study group demonstrated superior cost-effectiveness, with a CER of 173.09 THB per 1 percentage point of reduced HbA1c levels (as compared to 336.94 THB per percentage point by the comparison group). Additionally, the study group revealed an Incremental Cost-Effectiveness Ratio (ICER) of only 49.63 THB per 1 percentage point of HbA1c reductions.

Conclusion: The Diabetes Remission clinic, which emphasizes small groups undergoing lifestyle modifications, medication reduction and support from village health volunteers, is more efficient and cost-effective than the standard care model. This approach should be supported in primary care settings to improve long-term health outcomes for diabetic patients.