Too Few at Risk for Type 2 Diabetes Referred to Prevention Programs

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istock/Igor Alecsander

Research has shown that people at increased risk for type 2 diabetes who take part in a Diabetes Prevention Program (DPP) can delay and even prevent the disease’s development. But far too few people in the United States who are at risk for diabetes are advised to take advantage of such programs, according to a study published in 2019 in JAMA Network Open.

Researchers analyzed data from 50,912 overweight or obese adults who answered the 2016- 2017 National Health Interview Survey (NHIS). All were at high risk of diabetes based on a physician diagnosis of prediabetes or an elevated American Diabetes Association (ADA) risk score.

Among those who had been diagnosed with prediabetes, 73 percent reported being advised by their healthcare provider in the past year about activities to lower diabetes risk, such as increasing physical activity, consuming fewer calories and less fat, or participating in a weight loss program. However, only about 5 percent were referred to a formal prevention program.

Among respondents with an elevated ADA risk score, only 50 percent reported receiving any advice on how to reduce their risk of developing diabetes. Of that group, just 0.4 percent were advised to join a DPP. Overall, of patients who were advised to join a program, 40 percent did so.

Participation in a DPP is a proven winner. If you have prediabetes or risk factors for diabetes, ask your doctor for a referral to a program near you. Online programs are available, too, and they have shown impressive results. For example, a 2015 study from the University of California, San Francisco, and others showed that people who completed an online intensive behavioral change program that met DPP criteria lost an average of 5 percent of their body weight, and they brought their A1c levels down an average of 0.4 percent That’s enough for many to avoid developing type 2 diabetes. Similar results were reported at a two-year follow-up.

In a 2016 study published in PLOS One, researchers looked specifically at people 65 and older. The scientists tracked 1,121 overweight or obese seniors with prediabetes who participated in a DPP program that included an intensive 16-week online diabetes education course followed by online personal coaching and participation in an online community of other people with prediabetes. Participants who successfully completed the program lost 7.3 percent of their body weight. The program reduced the incidence of diabetes by up to 41 percent over the following five years.

Be aware that not all lifestyle change programs meet the criteria necessary for an effective diabetes prevention program. Go to https://nccd.cdc.gov/DDT_DPRP/Programs.aspx to find a list of online and in-person programs recognized as effective by the Centers for Disease Control and Prevention (CDC).