COMMENTARY

How Effective Are Diabetes Prevention Programs?

Ann Albright, PhD, RD

Disclosures

September 29, 2014

Editorial Collaboration

Medscape &

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Hello. I'm Dr Ann Albright, director of the Division of Diabetes Translation at the Centers for Disease Control and Prevention (CDC). I'm speaking with you as part of the CDC Expert Commentary Series on Medscape.

As you probably know, the number of people with diabetes continues to increase. It is critical that we prevent new cases of diabetes. You work hard to provide your patients with the best care possible, but you are busy and it can be hard to provide the counseling and guidance necessary for your patients to make sustained lifestyle changes. That's where we can help. CDC manages the National Diabetes Prevention Program, a lifestyle-change intervention that can help your patients prevent or delay type 2 diabetes.

The facts are clear:

29 million Americans have diabetes;

86 million Americans have prediabetes, but only 10% of them know they have it;

Diabetes is the seventh leading cause of death in the United States; and

Diabetes can lead to other serious health complications, including heart disease, stroke, blindness, kidney failure, and lower-extremity amputations.

And another fact is clear: Testing your patients for prediabetes and recommending evidence-based lifestyle programs can significantly impact whether they take action. Your referral matters to your patients.

The evidence is strong. These programs work. Both randomized clinical trials and real-world implementation studies have proven that structured lifestyle-change programs can help prevent or delay type 2 diabetes by 60% in people with prediabetes.[1,2,3,4]

Complementary improvements to the physical environment—like increasing availability of healthy food choices and opportunities for physical activity—can make it easier for everyone to make healthier choices. In addition, a structured lifestyle-change program is vital to reducing type 2 diabetes among people at high risk. These are both important.

Without moderate weight loss and increased physical activity, 15%-30% of people with prediabetes will develop type 2 diabetes within five years. The National Diabetes Prevention Program is the first coordinated, organized, unified effort to address diabetes prevention; programs are implemented locally and are scaled for national impact. It's a collaboration among government agencies, community-based organizations, employers, insurers, healthcare professionals, and others to make diabetes prevention resources more broadly accessible and affordable. Together, we can effect real, sustainable change.

The lifestyle intervention is based on sound behavior-change principles, it is kept relatively simple, and it gives patients the necessary dose of counseling and tools to make healthier choices. The program can be offered almost anywhere—churches, office buildings, community centers—any place a small group can gather, and even virtually, in some cases.

Diabetes is expensive for everyone. Current estimates show that total costs for diabetes are $245 billion per year in the United States. And we know that this intervention is cost-effective. Some healthcare insurers already cover the costs associated with the program, and we are working to expand that coverage nationally.

To ensure program quality, CDC set standards and established a Recognition Program. Its purpose is to certify organizations that have shown they can effectively deliver the lifestyle-change program. CDC tracks the progress of all organizations offering the program—ensuring that they consistently meet the same quality standards across the country. You can confidently refer your patients to CDC-recognized programs.

Simply put, this program works. Diabetes is a tremendous public health problem, and too many people are at risk. This program is critical for people with prediabetes, and you are critical to its success. You can:

Identify at-risk patients and screen for prediabetes;

Refer your patients to a CDC-recognized prevention program; and

Be a champion for the National Diabetes Prevention Program; your support will help increase access to this resource.

For more information and to find programs near you, please visit www.cdc.gov/diabetes/prevention. Thank you for all you do to help people prevent and delay type 2 diabetes.

Web Resources

CDC Diabetes Public Health Resource

CDC National Diabetes Prevention Program

CDC Diabetes Prevention Recognition Program

CDC National Diabetes Statistics Report, 2014

Find a Program Near You

Ann Albright, PhD, RD, is the Director of the Division of Diabetes Translation at the Centers for Disease Control and Prevention, where she leads an expert team that strives to eliminate the preventable burden of diabetes through leadership, research, programs, and policies that translate science into practice. Prior to commencing her post at the CDC, Dr Albright served as Chief of the California Diabetes Program for the California Department of Health Services. During this time, she also held an academic appointment at the Institute for Health and Aging at University of California, San Francisco. Dr. Albright served as the Senior Health Policy Advisor in the Office of the United States Surgeon General and led the Secretary of Health's Diabetes Detection Initiative. Dr Albright is well known for her work in diabetes, including the implementation of evidence-based diabetes care guidelines, work on models of care in community clinics, application of diabetes prevention, and development of campaigns to increase the understanding of diabetes and importance of blood glucose, blood pressure, and lipid control.

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