Research Description
The National Diabetes Prevention Program (NDPP) is a widely-available program to help people prevent diabetes through lifestyle change. Despite major successes, more work is needed to make the program better, especially for people who are at highest risk for developing the disease. We successfully adapted the NDPP (a version we call NDPP-Flex) to better help people reduce their risks for developing diabetes. In fact, NDPP-Flex participants were over 4-times more likely to have normal blood sugar at the end of the program compared to people who received the standard NDPP. We now want to do a more thorough study to confirm the benefits of NDPP-Flex, understand how the program helps to improve blood sugar, and whether differences vary by age, race/ethnicity, language, etc. We will recruit 200 diverse adults with prediabetes in a safety net healthcare system. The group who receives NDPP-Flex will be encouraged to set attainable, individually-tailored goals for risk-reduction; adjust their goals over time as needed; and avoid “pass/fail” judgements of their progress. In contrast, standard NDPP delivery is fairly strict with preset goals for ?5% weight loss and ?150 minutes of physical activity/week. Both groups will receive classes that are delivered remotely, including 25 sessions over one year that are led by bilingual (English-Spanish) lifestyle coaches. We will measure outcomes including blood sugar, weight, diet, physical activity, perceived control, perceived stress, and motivation. We have led multiple studies like this since 2013, which shows our ability to successfully lead the proposed study.Research Profile
What area of diabetes research does your project cover? What role will this particular project play in preventing, treating and/or curing diabetes?We propose to test an adapted National Diabetes Prevention Program to improve outcomes and lessen health disparities for type 2 diabetes. Our preliminary research shows that our adaptation, NDPP-Flex, can improve blood sugar through patient-centered goal setting. Expanding this body of evidence may help to modernize clinical guidelines for diabetes prevention. This project aims to prevent diabetes by helping more people with prediabetes make small changes to get back to having normal (or closer-to-normal) blood sugar levels, which can help prevent progression to diabetes in the future.
If a person with diabetes were to ask you how your project will help them in the future, how would you respond?This project is intended to help people avoid getting diabetes in the first place. We are excited to have the chance to help people choose their own goals for diabetes prevention in a way that meets their needs. For a long time, providers have been focused on telling patients what to do, including how to lose weight, but it has not worked well for everyone as hoped. We need to better understand how to meet people “where they are at” in a way that better helps lower their risks for diabetes.
Why important for you, personally, to become involved in diabetes research? What role will this award play?I love the fact that diabetes is preventable, and it would give my life great meaning to use my training, skills, and resources to help more people prevent diabetes in the first place. And just like most people, I have had personal experience being at risk for diabetes and seeing diabetes affect my loved ones. It is exciting to think about a world where everyone has access to the knowledge and resources to prevent diabetes. Having the resources to rigorously conduct a clinical trial is a gift! This award will help us answer our research questions as definitively as possible, and be well-equipped to share the findings with the scientific community. This award also allows me to continue my research agenda of contributing to larger efforts to make the National Diabetes Prevention Program effective for as many people as possible.
In what direction do you see the future of diabetes research going?As a behavioral scientist, I am eager to better understand how people can make healthy and long-lasting changes in their lives to prevent diabetes. At the same time, I wonder if someday other scientists will develop some type of laser, gene-editing, or other high-tech way of helping the human body to manage glycemia better without any effort!