Diabetes Prevention Recommendations Updated

Lara C. Pullen, PhD

July 14, 2015

The Community Prevention Services Task Force recommends that healthcare systems and communities provide counseling and longitudinal support to individuals who are at increased risk for type 2 diabetes. Moreover, patients at risk for diabetes should be encouraged by their healthcare providers to participate in such programs. The task force also notes that economic studies show these programs are cost-effective.

The Community Preventive Services Task Force Recommendation Statement was written by Nicholas Pronk, PhD, and colleagues and accompanying editorial.

The task force recommendations are based on a systematic review of 53 studies describing 66 programs. The review found that combined diet and physical activity programs are effective at improving cardiometabolic risk factors and decreasing the incidence of diabetes in individuals who are at increased risk for both of these conditions. The review also noted that more intensive programs are more effective.

In 2010, the US Congress authorized the Centers for Disease Control and Prevention (CDC) to initiate the National Diabetes Prevention Program to prevent or delay type 2 diabetes. As part of this program, the CDC, YMCA of the USA, and UnitedHealth Group joined forces to combine community program delivery with health payer and public financing. The effort serves as an example of how such programs can reduce the risk and burden of diabetes.

The task force also published a companion economic evaluation that concluded that the costs of such combined diet and activity programs are lowered when the programs are delivered to groups in the primary care setting or in the community. Specifically, the median incremental cost for a health payer to offer such a program is just $1819 per quality-adjusted-life-year gained.

Effective implementation of such programs could result in improved quality of life for the millions of Americans who are at risk for diabetes. Unfortunately, only 1 in every 13 Americans with prediabetes are aware of their risk.

The authors have disclosed no relevant financial relationships.

Ann Intern Med. Published online July 13, 2015. Recommendation statement full text, Editorial full text

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