COMMENTARY

Refer Medicare Patients for Free Diabetes Prevention Program

Anne L. Peters, MD

Disclosures

March 22, 2018

This year, beginning April 1, our Medicare patients will be able to attend programs to help prevent diabetes. These programs are certified by the Centers for Disease Control and Prevention and are paid for by Medicare. They last 16 sessions and are based on the model used in the Diabetes Prevention Program.[1] Thus, we know that this model works. Although we also know that online programs can be effective, at the moment, Medicare will only pay for in-person programs.

I believe that this is an important benefit for our patients who are at risk of developing type 2 diabetes, and let me expand a bit further. In the Diabetes Prevention Program, they actually showed that older patients were somewhat better than younger patients at adhering to lifestyle changes. Even though we may believe that you can't teach old dogs new tricks, the older participants defied this. We saw the same thing in the Look AHEAD Study[2]; you can help patients change some of their lifestyle habits.

In the Diabetes Prevention Program, people did not have to lose 50 pounds. They only had to lose 7% to 10% of their body weight and keep it off to prevent the progression to diabetes. Indeed, I do not want older patients to lose too much weight. There is a natural weight loss that occurs with aging.

I want patients to change their health habits. If they can eat a little better, walk a little more, get some exercise, I believe that is a win-win. I do not want people to try to lose lots of weight or start running marathons. By and large, that can lead to injury.

What I would like people to do is to start moving more, to exercise a bit more. That is good for a variety of reasons, not only for diabetes prevention but in terms of joint pain, general well-being, and all sorts of other things.

As mentioned, these programs will be 16 sessions long. Instructors will teach patients the lifestyle tools they need to change their behaviors and coach them about how to do this.

To be eligible, a patient has to be diagnosed by you with prediabetes. That means having a glycated hemoglobin between 5.7% and 6.4% or a fasting blood glucose level between 100 and 125 mg/dL.

When you diagnose patients with prediabetes, I urge you to look for one of these programs, let patients know that it will be covered under Medicare as long as they have Medicare Part B, and encourage them to attend.

Editor's note: The CDC's National Diabetes Prevention Program website provides more information about screening and referring patients to a lifestyle change program, including tools and other resources, billing codes to get reimbursed, and a map to find classes near you.

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