Prediabetes is a Serious Health Condition That Affects Millions of Americans
People with blood glucose levels that are higher than normal, but not high enough to be diagnosed with type 2 diabetes, are considered to have prediabetes. In the U.S., 88 million adults in have prediabetes, but 85% of them don’t know they have it. Risk factors include being over the age of 45, having a family history of diabetes, being overweight, and not being physically active.
Without active intervention through lifestyle change, including changes to exercise and nutrition, prediabetes often progresses to type 2 diabetes. Type 2 diabetes can result in dangerous complications, including kidney damage, nerve damage, amputations, blindness, heart disease, and stroke. Early intervention is the first step on a path to prevent or delay the onset of type 2 diabetes.
The Centers for Disease Control and Prevention’s (CDC) National Diabetes Prevention Program Can Help
The National Diabetes Prevention Program—or National DPP—was created in 2010 to address the increasing burden of prediabetes and type 2 diabetes in the United States. This national effort created partnerships between public and private organizations to offer evidence-based, cost-effective interventions that help prevent type 2 diabetes in communities across the United States.
One key feature of the National DPP is the CDC-recognized lifestyle change program, which is based on research led by the Diabetes Prevention Program1—designed by the National Institutes of Health (NIH)—and focuses on nutritional and physical activity modification for individuals with prediabetes, as well as those who are at risk for type 2 diabetes. The year-long program follows a research-based curriculum that starts with weekly group meetings for the first six months, followed by routine upkeep sessions to keep participants on track. Research has shown that people with prediabetes who take part in this structured lifestyle change program can cut their risk of developing type 2 diabetes by up to 58% following the program, and that the reduction in risk continues for years to follow.
1Diabetes Prevention Program Research Group. (2002). Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. New England Journal of Medicine, 346, 393–403.
Standards of Medical Care in Diabetes
The Standards of Medical Care in Diabetes, written by the American Diabetes Association® (ADA), recommends that providers refer patients with prediabetes to a lifestyle change program that is modeled on the NIH’s Diabetes Prevention Program.
In addition, the U.S. Preventive Services Task Force (USPSTF) recommends that providers offer or refer patients with abnormal blood glucose to intensive behavioral counseling interventions—such as the National DPP—to promote a healthy diet and physical activity.
Relevant ICD-10 codes for prediabetes.
The ADA’s Involvement in the National DPP
The ADA is committed to increasing participation in and access to the National DPP’s lifestyle change program. As part of its commitment to reduce the incidence of type 2 diabetes, the ADA is working with the CDC as a 1705 cooperative agreement recipient (Scaling the National Diabetes Prevention Program in Underserved Areas). The ADA provides training and technical assistance to seven underserved communities across the United States to implement the lifestyle change program.
For a lifestyle change program to become CDC-recognized, it must adhere to strict standards, including utilizing a CDC-approved curriculum, using only trained lifestyle coaches, and it must meet the standards for duration and intensity. To maintain CDC recognition, it must meet rigorous standards for attendance and weight loss, as well as other indicators that are assessed on a biannual basis through data submission to the CDC. CDC-recognized organizations are required to submit data on participant attendance, physical activity minutes, and changes in weight. The ADA works with its 1705 affiliate sites to submit the data through DPP Express, its Diabetes Prevention Program charting platform.
The Importance of Health Care Provider Referrals
Research shows that patients are more likely to engage in a preventive health behavior when their health care professional recommends it. Recommending patients to a CDC-recognized program is easy through a simple referral form. By participating in a bi-directional referral process, you can expect to receive regular updates on your patients so you can monitor their progress at enrollment and at six and 12 months.
Your patients can be eligible for a lifestyle change program if they have gestational diabetes or qualify through the results of three blood tests (A1C, fasting plasma glucose, and two-hour plasma glucose after a 75 gm glucose load), as well as through the ADA Risk Test. They can learn more about their risk for type 2 diabetes and how to connect to a CDC-recognized lifestyle change program by visiting diabetes.org/myrisk.
Are you a Diabetes Care and Education Specialist?
If you are a certified diabetes care and education specialist (CDCES), you also play an important role in directing people with prediabets to CDC-recognized lifestyle change programs. You can encourage patients to join a lifestyle change program in their area. You could include a segment in your DSMES programming that advises your patients with type 2 diabetes to refer their family members to a lifestyle change program as well. Those family members can visit diabetes.org/myrisk to learn more about their risk for type 2 diabetes, as well as access a searchable database of CDC-approved lifestyle change program around the United States. Patients can also find additional information on ADA’s website.
We also encourage you to learn more about starting a lifestyle change program in conjunction with your DSMES service to help proactively reduce the risk of diabetes among your community. CDC-recognized lifestyle change programs billable to Medicare for beneficiaries participating in the program. Review these CDC resources to prepare for offering and maintaining a program in your area.
For your data collection and reporting needs, check out the ADA’s DPP Express charting platform developed for programs providing a National DPP lifestyle change program.
Free Webinar Series with the National Diabetes Prevention Program at the ADA
ADA’s free webinar series offers the chance for you to learn more about prediabetes and the National DPP. View the webcasts for free continuing medical education/continuing education credits from the live webinar series (1 credit per webcast):
- What Health Care Providers Need to Know About Identifying and Treating People with Prediabetes
- What Health Care Providers Need to Know About the National Diabetes Prevention Program and the Benefits of a Structured Lifestyle Change Program for Patients
- What Health Care Providers Need to Know About Referring Patients to a CDC-recognized Lifestyle Change Program
The continuing education credits for this webinar series expire on December 31, 2021.