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Lower your patient's risk of developing Type II Diabetes

The following information is from the National Diabetes Prevention Coverage Toolkit:

Research studies and evaluations have repeatedly shown that interventions such as the National DPP lifestyle change program improve health outcomes and are cost-effective or cost-saving.

The Diabetes Prevention Program was a randomized clinical trial funded by the National Institutes of Health (NIH) and supported by the CDC that began in 1996. A total of 1,079 participants experienced a lifestyle intervention that resulted in a 58% reduction in the rate of diabetes. The goals of the intervention were a 7% reduction in weight and 150 minutes a week of physical activity. It featured individual coaching, a 16-session core curriculum, supervised physical activity, and other supports.

10 and 15-year follow up studies were also completed. The 15-year follow up study substantiated that diabetes incidence was reduced by 27% in the group that experienced the intervention, and that “cumulative diabetes incidences” was 55% as compared to 62% in those who had not had an intervention.

For more information on the Diabetes Prevention Program clinical trial, click here.

Learn More About the Y's Diabetes Prevention Program

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Added Benefits of the Diabetes Prevention Program

This study assessed the cost-effectiveness of the National DPP lifestyle change program in a large workforce with employer-sponsored insurance. The lifestyle change program was offered to adult employees, dependents, and retirees who had prediabetes and were overweight or had obesity. Their analysis found that National DPP lifestyle change program participants included in the study had an average reduction of $4,552 in two-year total direct medical costs. Cost savings were attributed to avoidance or reduction of hospitalizations, outpatient visits, and emergency room visits. 

For more information, click here.

Diabetes has both serious health and economic consequences. These latest figures from the American Diabetes Association indicate direct and indirect estimated annual costs of $412.9 billion as a result of diabetes, individuals with diabetes face on average 2.6 times higher health care costs than those without diabetes, and 1 in 4 health care dollars are spent treating diabetes and its
complications.

To learn more, click here.

Several studies have found that lifestyle intervention programs can reduce the risk of cardiovascular disease. For example, a 2005 randomized clinical trial found that an intensive lifestyle intervention designed to achieve and maintain a 7% weight loss and 150 minutes of exercise per week decreased the incidence of metabolic syndrome (i.e., increased blood pressure, high blood sugar, excess body fat around the waist, and abnormal cholesterol or triglyceride levels that occur together) by 41%.

The National DPP lifestyle change program can also improve general health, physical function, reduce bodily pain, and improve vitality scores on a health survey after three years. Similarly, another study concluded that weight loss because of the National DPP lifestyle change program was associated with improvements in measures of health-related quality of life. Finally, a study of a work place diabetes prevention lifestyle change program found improved metabolic and behavioral risk factors among employees with prediabetes.

Individuals with higher HbA1c levels may have poorer brain health and increased cognitive decline compared to individuals with normal levels. One study shows memory loss as the most reported adverse side effect of prediabetes and known diabetes, but these conditions are also associated with poorer processing speed, concentration, attention, and executive functions. Specifically, prediabetes and known diabetes are positively associated with vascular dementia (VD), cognitive decline, Alzheimer’s dementia (AD) risks, lower hippocampal volume (HV), and white matter hyperintensities (WMH) volume.

Another benefit of the National DPP lifestyle change program is the reduction of sleep apnea. A study of obese adults with type 2 diabetes and obstructive sleep apnea found that over four years, intensive lifestyle intervention produced greater reductions in weight and sleep apnea than diabetes support and education only. An analysis of two systematic reviews and eight randomized control trials of overweight or obese individuals who had obstructive sleep apnea also found that intensive lifestyle interventions resulted in significant weight loss and reduction in sleep apnea severity. Similarly, a systematic review and meta-analysis of 12 controlled trials found that intensive lifestyle management can significantly reduce obesity indices and decrease the severity of sleep apnea.

Are your patient's eligible for the Diabetes Prevention Program?

Check below to see Eligibility Criteria

Patients on Medicare Plans

  • Enrolled in Medicare Part B (see CMS’s How to Verify an MDPP Beneficiary’s Medicare Coverage document)

  • BMI ≥ 25; or ≥ 23 if self-identified as Asian

  • A1c (HgA1c) between 5.7 and 6.4%, or

    • Fasting Plasma Glucose (FPG) test result of 110–125 mg/dL, or

    • 2-hour Post-Glucose Challenge Test result of 140–199 mg/dL (oral glucose tolerance test) within the previous 12 months

  • No previous diagnosis of type 1 or type 2 diabetes (except for a prior diagnosis of gestational diabetes)

  • Does not have end-stage renal disease (ESRD) at any point during the MDPP services period

Additional Notes:

  • The MDPP benefit is available for coverage only once per lifetime.

  • Referrals are not required, but the following are allowed (with qualifying blood test results):

    • Self-referral from participant

    • Community referral

    • Physician referral

    • Other health care practitioner referral

CDC Eligibility Requirements

  • Program participants must meet the following criteria:

    • Be 18 years of age or older (program is intended for adults at high risk of developing type 2 diabetes)

    • Have a BMI ≥ 25 kg/m² (≥ 23 kg/m² if Asian American)

  • Participants must also be considered eligible based on one of the following:

    • Blood test result within one year of enrollment (may be self-reported for CDC recognition, but not for MDPP participants—lab results required):

      • Fasting glucose of 100–125 mg/dL (CMS requirement for MDPP: 110–125 mg/dL)

      • Plasma glucose of 140–199 mg/dL measured 2 hours after a 75g glucose load

      • HbA1C of 5.7–6.4%

    • Clinically diagnosed gestational diabetes mellitus (GDM) during a previous pregnancy

      • Allowed for CDC recognition (may be self-reported)

      • Not allowed for MDPP participants

    • Positive screening for prediabetes using the CDC/ADA Prediabetes Risk Test (not valid for MDPP participants)

  • Additional requirements:

    • Participants cannot have a previous diagnosis of type 1 or type 2 diabetes prior to enrollment

    • Participants cannot be pregnant at the time of enrollment

    • A health care professional may refer participants, but referral is not required for CDC-recognized programs

Program Standards:

  • To be eligible, individuals must have qualifying blood test results, a history of gestational diabetes, or a positive Prediabetes Risk Test score

  • CDC DPRP standards require at least 35% of participants be diagnosed with prediabetes through blood testing (or have a history of GDM)

  • The remaining participants may qualify based on Prediabetes Risk Test scores

  • The CDC/ADA Prediabetes Risk Test is a 7-question survey designed to estimate prediabetes risk

  • Regular biometric screenings can also help determine eligibility