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Concurrent Session at Preventive Medicine 2016

Preventing Diabetes with Lifestyle Interventions

An inspiring panel of speakers at Preventive Medicine 2016 explained how community-level integration of the National Diabetes Prevention Program is setting the standard for utilizing lifestyle interventions to improve public health and patient outcomes.

From left to right: Matt Longjohn, YMCA; Elizabeth Kraft, Anthem Blue Cross; Liana Lianov, HealthType; Ann Albright, CDC; Karen S. Kmetik, AMA; Dani Pere, ACPM; Mike Payne, Omada Health.

An estimated 86 million Americans have prediabetes and approximately 15-30% of them will develop type 2 diabetes in the next five years. However, that risk may be reduced or eliminated through weight loss, healthier eating, and increased physical activity. As a part of our lifestyle medicine programs, ACPM is increasingly focused on raising awareness of testing for prediabetes and referring patients to evidence-based programs to prevent the occurrence of type 2 diabetes.

"You indeed can delay or prevent type 2 diabetes in those at high risk," said Ann Albright, director of the Division of Diabetes Translation at the U.S. Center for Disease Control and Prevention (CDC), speaking on a panel about preventing diabetes at Preventive Medicine 2016. Organized by the American College of Preventive Medicine, the session brought together leaders from organizations who are designing, implementing, and paying for patients to enroll in the National Diabetes Prevention Program (NDPP).

Ann Albright

The NDPP, a lifestyle change program developed by the CDC, adheres to evidence-based curriculum standards, uses trained coaches to guide patients through the year-long program, and employs support groups to increase success rates. Across the country, CDC-recognized providers are reporting over a 50% reduction in the risk of type 2 diabetes among enrollees.

ACPM member and moderator Liana Lianov said the NDPP is the strongest evidence-based program that currently exists showing the value and effectiveness of lifestyle medicine to reduce chronic disease.

Established national standards guide community-based providers administering the program. The result is a reliable service that doctors trust and is effective for patients. The CDC and its partners are now focusing their energy on increasing the number of providers, trained workforce, and referrals to the program.

"We may be turning a corner and headed for an overall decline in the prevalence of diabetes," said Albright, "but it means we need to double down on prevention and to work along the full spectrum of risk, not just with patients at the most risk."

To improve awareness of prediabetes, the CDC, American Medical Association, and American Diabetes Association have teamed up with the Ad Council to create the 'Do I Have Prediabetes?' campaign. Videos armed with humor educate patients about the importance of diagnosing prediabetes and preventing type 2 diabetes through changes in lifestyle.

"It's about empowering people—that [prediabetes] really is a precursor to type 2 diabetes. But it is reversible with lifestyle changes and by losing a little bit of weight," said Karen S. Kmetik of the American Medical Association. Kmetik also stressed the significant role doctors play in getting eligible patients to enroll in a program, because roughly 90% of patients with high blood glucose levels don’t even know they have prediabetes. Professionals may also not be aware that many insurance providers are willing to cover the cost of enrollment in the NDPP, including some Medicare and Medicaid plans.

For Elizabeth Kraft and her organization, Anthem Blue Cross Colorado and Nevada, the NDPP represents the opportunity to engage in a proactive, collaborative approach with healthcare providers to simultaneously improve patient health and save employers money. The program’s standards and success rates also make covering their patients’ enrollment a no-brainer, said Kraft, reporting that Anthem at least breaks even on their financial investment across all enrolled patients.

Elizabeth Kraft, Karen S. Kmetik, and Ann Albright

"We need more community doctors pounding the table with health plans, demanding to make diabetes prevention a core part of coverage," said Mike Payne, chief commercial officer and head of Medical Affairs at Omada Health, one of two representatives at the meeting who spoke about how their organizations are implementing the program and helping prevent diabetes nationally.

Mike Payne and Matt Longjohn

Omada Health—one of the largest providers with over 36,000 enrolled patients—offers an online program that is seeing success rates comparable with the in-person programs. "We’re not a tech company. We’re a healthcare company that uses tech to deliver behavioral medicine," said Payne, adding that the use of the online platform may also allow for data science to improve outcomes over time.

In another feat of implementation, local YMCAs in over 220 cities nationwide are implementing their diabetes prevention program "everyday on the decks of pools, in camps, church basements, and school cafeterias," said Matt Longjohn, national health officer at the YMCA of the United States of America. "The Y changes every generation to meet the needs of that generation—as community needs change, we change." Longjohn also said the YMCA can work with any insurance provider and strives to never turn anyone away from participating in the NDPP due to cost.

Because of the diligent efforts of public and private partners, the NDPP is succeeding nationally to address the diabetes epidemic. And for many patients with prediabetes, this local, affordable, and high-quality lifestyle change program is effectively reducing their risk of type 2 diabetes and improving their overall health.

Learn more about the evidence-based National Diabetes Prevention Program on the CDC website, and find what program providers in your community are helping patients reduce their risk of developing type 2 diabetes. This concurrent session from Preventive Medicine 2016 will be available through ACPM’s e-learning portal soon for those who were not able to attend.

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