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To synthesize updated evidence on the cost-effectiveness (CE) of interventions to manage diabetes, its complications, and comorbidities.

We conducted a systematic literature review of studies from high-income countries evaluating the CE of diabetes management interventions recommended by the American Diabetes Association (ADA) and published in English between June 2008 and July 2017. We also incorporated studies from a previous CE review from the period 1985–2008. We classified the interventions based on their strength of evidence (strong, supportive, or uncertain) and levels of CE: cost-saving (more health benefit at a lower cost), very cost-effective (≤ 25,000perlifeyeargainedLYGorquality-adjustedlifeyearQALY),cost-effective( 25,001–50,000perLYGorQALY),marginallycost-effective( 50,001–100,000perLYGorQALY),ornotcost-effective(> 100,000 …