American Journal of Preventive Medicine
Diabetes prevention at the national levelA Coordinated National Model for Diabetes Prevention: Linking Health Systems to an Evidence-Based Community Program
Section snippets
Background
Twenty-six million U.S. adults have diabetes, and 79 million have prediabetes. In 2002, a Diabetes Prevention Program research study proved the effectiveness of a lifestyle intervention that yielded a 58% reduction in conversion to type 2 diabetes. In 2010, the National Diabetes Prevention Program was created by Congress and provides the overarching architecture to organize nationwide programs to prevent diabetes through changes in lifestyle. This study describes the collaborative,
Design
Participants with prediabetes are enrolled in the YMCA's Diabetes Prevention Program (YMCA's DPP), a 12-month community-based initiative. As a service provider, the YMCA's DPP uses the DPCA infrastructure for support with tasks such as managing content and collecting patient data. Local YMCAs are compensated for successful program delivery based on enrollment, program completion and final individual participant outcomes, particularly for weight loss. Nearly 60% of the U.S. population lives
Results
In the first 18 months of operations, the YMCA's DPP was effectively scaled to 46 communities in 23 states where it was reimbursed through private payers, self-insured employers, and CDC funding. More than 500 YMCA Lifestyle Coaches have been trained to administer the lifestyle change program. As of January 31, 2012, a total of 2369 individuals have participated in the YMCA's DPP, and another 1053 are currently active in the core program. As of January 31, 2012, a total of 1723 participants
Discussion
The original 2002 Diabetes Prevention Program research study demonstrated that significant reduction in the risk of progressing from prediabetes to diabetes could be achieved, but also raises the question: Why was so little done by the wider healthcare community in the years following the publication of the research study results to bring the new intervention to scale and to ensure it had a broad impact on population health? The absence of such action illustrates one of the challenges
References (18)
- et al.
Diabetes risk reduction behaviors among U.S. adults with prediabetes
Am J Prev Med
(2010) National diabetes fact sheet: national estimates and general information on diabetes and prediabetes in the U.S., 2011
(2011)Number (in millions) of civilian, non-institutionalized persons with diagnosed diabetes, U.S., 1980–2008
(2010)- et al.
Value of elderly disease prevention
Forum Health Econ Policy
(2006) UnitedHealthcare employer-sponsored membership allowed costs (medical and prescription drugs) in 2009 drawn from a national sample of 10 million membersThe United States of diabetes: challenges and opportunities in the decade ahead
(2010 Nov)- et al.
Relation of impaired fasting and postload glucose with incident type 2 diabetes in a Dutch population: the Hoorn Study
JAMA
(2001) Screening for type 2 diabetes mellitus in adults, topic pageUSPSTF
(2008)Standards of medical care in diabetes
Diabetes Care
(2010)- et al.
Effective interventions for stemming the growing crisis of diabetes and prediabetes: a national payer's perspective
Health Aff (Millwood)
(2012)
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