Investing in diabetes prevention could pay off in Canada

A new study highlights the value of investing in a publicly funded diabetes prevention strategy inspired from England's successful program

Source: CMAJ and The Institute

Adopting a diabetes prevention program (DPP) in Canada similar to the National Health System (NHS) England program could help prevent type 2 diabetes in people with prediabetes and save costs, according to a new study from researchers from the Research Institute of the McGill University Health Centre (The Institute) and McGill University, with NHS DPP founder Dr. Jonathan Valabhji.

"Our analyses indicate that implementing an NHS-style DPP in Ontario and Quebec would be cost-effective-and likely cost saving-over a 35-year horizon for adults with prediabetes," write postdoctoral student Dr. Nisha Gupta, senior author Dr. Kaberi Dasgupta, and their co-authors, in the study published in CMAJ(Canadian Medical Association Journal).

There are no publicly funded DPPs in Canada, despite estimates that as many as 1 in 4 adults in the country have prediabetes, meaning their blood sugar levels are higher than normal but not high enough for a diabetes diagnosis. Recognizing the need for greater prevention efforts, Canada released a diabetes framework in 2022 that calls on provincial and Indigenous governing bodies to build community-based programs to help address increases in new cases of diabetes.

Preventing is cheaper than treating

Based on evidence from clinical trials in a range of countries that showed structured programs combining dietary and physical activity can prevent diabetes in people with prediabetes, the NHS England adopted the world's first national, publicly funded DPP.

"England's experience shows that it is possible to implement effective public type 2 diabetes prevention programs, and our present and past work shows that similar programs could be offered in Canada" says Dr. Dasgupta, a senior scientist in the Metabolic Disorders and Complications Program at The Institute. "For society, preventing diabetes is a beneficial economic choice. For the individual, it's a choice for a healthier and simpler life-and that's priceless."

Together with colleagues from the United Kingdom, the team of researchers conducted a modelling study to determine if adopting an NHS-style DPP would be cost-effective in Canada.

They modelled the introduction of a DPP in Quebec and Ontario over 35 years. Their findings show that the program would require a one-time investment of about $760 per participant in Quebec and $920 in Ontario. However, by preventing or delaying some cases of type 2 diabetes, the program would reduce health-care costs over time. These savings would more than offset the initial cost of the program, resulting in net savings to the health system of about $244 per participant in Quebec and $242 in Ontario over 35 years. At the same time, participants would experience better health outcomes, as measured in quality-adjusted life years (QALYs).

In other words, investing in diabetes prevention could both reduce long-term health-care costs and improve health outcomes.

"The NHS DPP represents a compelling model for Canada, given its demonstrated cost effectiveness and the structural similarities between English and Canadian health systems. In both Canada and England, the majority of the population is White, but both countries have large proportions of people from other racial or ethnic backgrounds," write the authors.

However, they note that Canada would need an Indigenous-led DPP program to meet the specific needs of Indigenous peoples to align with the Truth and Reconciliation Commission's Calls to Action to address colonial injustices.

"Our findings support the potential DPPs in Canadian provinces and highlight an opportunity to reduce value of investing in the burden of type 2 diabetes. Successful implementation in a single province could facilitate broader adoption, reduce the number of people developing type 2 diabetes and downstream health care costs, and inform future federal coordination and funding efforts," they conclude.

About the study

"Cost-effectiveness of implementing the National Health Service England Diabetes Prevention Programme to the Canadian context in Canada: a cost-effectiveness modelling study" is published September 28, 2026 in CMAJ.