Diabetes Prevention Program Has Promising Results Over First 4 Years

Early returns on the National Diabetes Prevention Program (DPP) show it’s working, and that the higher the level of participation, the better the results.

A study published Friday in Diabetes Care evaluated data from 14,747 adults who took part in the yearlong program between February 2012 and January 2016, and found that participants took part in an average of 14 sessions over an age of 172 days. The average weight loss was 4.2%, and the median weight loss was 3.1%. The study also found that 41.8% met the physical activity goal of 150 minutes per week.

The study found a direct connection between the number of classes a person attended and the results: For every additional session attended and 30 minutes of physical activity, participants lost 0.3% of body weight. This may have important implications for program design, as both CMS and groups that offer the DPP look to boost retention rates.

The DPP seeks to help participants with prediabetes lose between 5% and 7% of body weight, a level that that is considered “transformational” because evidence shows it greatly reduces the likelihood that the person will progress to type 2 diabetes (T2D).

The National DPP was launched in 2010, after the National Institutes of Health developed the program and published the results from a clinical trial on its effects in 2002. Findings show the program reduced the risk progression to diabetes by 58%, and by 71% for those age 65 and older.

As the population ages, CMS is looking for ways to reduce the share that ends up with T2D, because already $1 of every $3 in Medicare spend is on diabetes—a percentage that officials have said is not sustainable. An estimated 86 million people in the United States have prediabetes, but 9 in 10 have no idea.

Based on a pilot program with the YMCA, CMS announced in March 2016 that it would begin offering the DPP through Medicare, after its actuary found that the government could save $2650 over 15 months for each person enrolled in the program. CMS has issued some rules on how the program will operate in Medicare, and another round is expected in June, which should contain specifics for digital providers. DPP is set to start in Medicare in January 2018.

DPP takes place over 12 months; in its original, in-person format, participants meet for weekly sessions for the first 16 weeks, known as the “core sessions.” After that, participants met monthly for maintenance sessions.

There is hope that digital providers will help the DPP reach more men, since the population in the Diabetes Care study was 81% female. Brenda Schmidt, CEO of Solera Health, which offers technology and support services for DPP programs, said in a previous interview with The American Journal of Managed Care^® that digital programs could offer significant opportunities for closing the gap with men.

The study authors wrote that focusing on reasons why some delivery methods have better retention than others may help reduce disparities, and bring better overall results.

“Further program expansion is needed to continue lowering the burden of type 2 diabetes nationally,” they wrote.

Reference

Ely EK, Gruss SM, Luman ET, et al. A national effort to prevent type 2 diabetes: participant-level evaluation of CDC’s National Diabetes Prevention Program [published March 12, 2017]. Diabetes Care. 2017; https://doi.org/10.2337/dc16-2099.