Ann Albright, PhD, RD


July 08, 2015

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We have 86 million people in the United States with prediabetes, but very few of them—only about 10%—know that they have prediabetes. Clearly, we need to do something about that. In 2010, Congress authorized the Centers for Disease Control and Prevention (CDC) to establish the National Diabetes Prevention Program (DPP). This is our opportunity to take lifestyle interventions and get the data and evidence scaled to a degree that is actually going to have an impact on public health.

These past few years we have been setting up the National DPP. It has caused us to work with a variety of groups and a variety of populations. The original DPP research study demonstrated that the intervention is even more effective in patients older than 60 years of age. It is 58% effective for the general population and 71% effective for those older than 60 years of age. This is certainly a population that will benefit from this intervention. To that end, the Centers for Medicare & Medicaid Services (CMS) has given out some grants to help study this.

One of the studies is looking at what the YMCA is doing to implement this intervention for Medicare beneficiaries. We know that the intervention works in this population, so it's really a question of how you engage this population. How do you get them involved? How do you reimburse for this? What is the ability of CMS to really engage in this process?

That demonstration project is underway. When they moved from only Medicare fee-for-service participants to including Medicare Advantage, they were able to increase participation in the study. We expect to get the results from that study in 2016. Right now, the information coming out of there is looking very promising. Time will tell whether CMS will reimburse for this intervention. That is one avenue that is being taken to get coverage for this older population.

Other avenues that are being taken are current bills before the legislature, a House version and a Senate version, that would require the National DPP to be a covered benefit for Medicare beneficiaries. This is the third time that the bill has been introduced and, again, time will tell whether that is an avenue for getting coverage.

We have amazing partnerships going on in the National DPP. One of the most recent partnerships has been the American Medical Association (AMA) joining forces with a number of our partners. The AMA has made a several-year commitment to help get physicians engaged in testing their patients for prediabetes and then referring them to diabetes prevention programs that are recognized by the CDC and communities.

This is an exciting time for us to be engaged in this issue and to be driving traffic to these programs. This is our time to make the lifestyle prevention program, which has been proven to prevent type 2 diabetes, a reality in the country, particularly for our older adults.


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