Eighty-four million people – more than one of three adults in the U.S. – have prediabetes. Nine out of 10 don’t even know they have it. It’s time to do something about it, says Ann Albright, PhD., RD, director of the Division of Diabetes Translation, National Center for Chronic Disease Prevention and Health Promotion, U.S. Centers for Disease Control and Prevention.
The blood glucose levels of people with prediabetes are higher than normal, though not high enough to be diagnosed as type 2 diabetes. The good news is, prediabetes can – with effort – often be reversed.
The CDC-led National Diabetes Prevention Program (National DPP) – which Albright helped develop – is designed to help people with prediabetes participate in evidence-based, affordable, and high-quality lifestyle-change programs to reduce their risk of type 2 diabetes and improve their overall health.
Year-long program
Established by the Diabetes Prevention Act of 2009, the year-long program consists of a series of sessions providing information, group support, and offering feedback in stages to optimize behavioral change. Programs are offered in a group setting, online, or other virtual approaches, and are led by lifestyle coaches who are trained to use a CDC-approved curriculum and who have the knowledge and skills to effectively deliver the program.
Goals should focus on moderate changes in both diet and physical activity to achieve modest weight loss over the first six months, in the range of 5 percent to 10 percent of baseline body weight. Strategies used to achieve these goals must include a focus on self-monitoring of food intake and physical activity, building of self-efficacy and social support for maintaining lifestyle changes, and problem-solving strategies for overcoming common challenges to sustaining weight loss.
“It is a structured, highly-evidence-based program for preventing or delaying type 2 diabetes,” says Albright.
“We have used the evidence from the original randomized trial along with subsequent studies and translated it, creating an infrastructure that allows the program to be delivered at a national level by trained diabetes prevention coaches in churches, YMCAs, and community centers throughout the country.
“More than 1,500 organizations currently offer the intervention, to more than 155,000 people for which we currently have data,” says Albright. The average weight loss is 4.1 percent. “As a nation, we’re striving for 5 percent average weight loss,” she says. Over 70 commercial health plans provide some form of coverage for the program, and starting in April 2018, Medicare will pay for delivery of the program. Insofar as Medicaid is concerned, two states currently provide coverage, two will begin in 2018, and 20 more are working on it.
The long haul
“Type 2 diabetes prevention calls for moderate, long-term lifestyle change, and the need for it is urgent,” says Albright. “Because diabetes is like a rock in a pond – meaning it increases the risk of other chronic conditions and diabetes complications such as hypertension, hyperlipidemia, sleep apnea, amputation, and kidney failure – it’s critical that we achieve type 2 diabetes prevention.
“We have to begin taking lifestyle change seriously. We have to stop wringing our hands, and we need to be problem solvers and focus on addressing the barriers for people getting into the program and sustaining lifestyle changes. It’s a significant undertaking, but over the last four years we have made substantial progress with all of the stakeholders who have joined in to help reduce the burden of diabetes in this country.”
In 2015, the American Medical Association and CDC joined forces to launch a multi-year initiative intended to reach more Americans with prediabetes and stop the progression to type 2 diabetes. Prevent Diabetes STAT: Screen, Test, Act – Today™, aims to sound an alarm and shine a light on prediabetes as a critical and serious medical condition.
The initiative includes tools to help physicians incorporate type 2 diabetes prevention (screening, testing and referring patients) into their practices, and to promote prediabetes awareness among their patients.
Spreading the word
CDC continued its work to increase prediabetes awareness the following year with the launch of the nation’s first prediabetes awareness campaign. Launched January 2016 in partnership with the Ad Council, the AMA and the American Diabetes Association, this national effort encouraged people to learn their risk for prediabetes by visiting the campaign website, DoIHavePrediabetes.Org and taking a one-minute risk test.
Earlier this year CDC partnered with CBS to launch “Your Health with Joan Lunden and CDC,” a televised and digital mini-series in which CBS host Joan Lunden, Albright and special guests explore diabetes, prediabetes and related topics.
“We have to work on preventing new cases of type 2 diabetes, and improving outcomes for those with diabetes,” says Albright. “There are many pieces to solving this puzzle, but with the National DPP, we are working to make sure this evidence-based lifestyle program is in place and available to the people who need it. As the common defense against health threats for the country, we remain committed to using our available science, surveillance and service to work with stakeholders and reduce the impact of diabetes in the U.S.”
Prediabetes checklist
Organizations participating in the CDC-led National Diabetes Prevention Program must use an approved curriculum that meets the CDC requirements for recognition. CDC offers two curriculums in English and Spanish: the 2012 National DPP curriculum and the Prevent T2 curriculum. Organizations may also develop and use their own curriculum, though it must be submitted, reviewed, and approved by CDC prior to its use.
The PreventT2 curriculum is based on the original 2002 DPP trial and follow-up studies. It promotes modest weight loss (5-7 percent) and increased physical activity through a 12-month lifestyle change program, and also reflects new literature on self-efficacy, physical activity and diet. There are 26 modules.
First six months
Organizations must present all 16 of the following modules within the first six months. “Introduction to the Program must come first.” Otherwise, there is no required order. However, CDC recommends that organizations present the next six modules in the order listed, since they provide the foundation upon which the rest of the curriculum is based. CDC recommends presenting Stay Motivated to Prevent T2at the six-month mark.
- Program Overview
- Introduction to the Program
- Get Active to Prevent T2
- Track Your Activity
- Track Your Food
- Eat Well to Prevent T2
- Get More Active
- Burn More Calories Than You Take In
- Shop and Cook to Prevent T2
- Manage Stress
- Find Time for Fitness
- Cope with Triggers
- Keep Your Heart Healthy
- Take Charge of Your Thoughts
- Get Support
- Eat Well Away from Home
- Stay Motivated to Prevent T2
Second six months
Organizations must present at least six of these 10 modules during the last six months. Prevent T2 – for Life! must come last. Otherwise, there is no required order.
- When Weight Loss Stalls
- Take a Fitness Break
- Stay Active to Prevent T2
- Stay Active Away from Home
- More About T2
- More About Carbs
- Have Healthy Food You Enjoy
- Get Enough Sleep
- Get Back on Track
- Prevent T2 – for Life!
Your risk for prediabetes
Type 2 diabetes can be delayed or prevented in people with prediabetes through effective lifestyle programs, according to the Centers for Disease Control and Prevention, which advises people to take the following test to determine their risk for prediabetes. The more “yes” answers, the greater the risk of prediabetes.
- Do you have a mother, father, sister or brother with diabetes?
- Have you ever been diagnosed with high blood pressure?
- How old are you?
- What race or ethnicity best describes you?
- Are you physically active?
- Are you a man or a woman?
- Have you ever been diagnosed with gestational diabetes?
- How tall are you?
- How much do you weigh?
Source: DoIHavePrediabetes.Org
https://doihaveprediabetes.org/prediabetes-risk-test.html
Link to Full Article: A Head Start on Diabetes- Eating right, staying active, can turn the tide on prediabetes