Long-term commitment to diabetes prevention increases success

During its first four years, the Center for Disease Control and Prevention’s National Diabetes Prevention Program (NDPP) has seen widespread implementation and promising early results, according to a study published recently in Diabetes Care.

The NDPP was designed to prevent type 2 diabetes in individuals at risk by using structured lifestyle change programs. Data from this study showed that more than one-third of participants achieved a 5% weight loss.

“Diabetes takes a significant toll on the public’s health and on our nation’s healthcare systems and payers,” Elizabeth K. Ely, from the division of diabetes translation at the Centers for Disease Control and Prevention, told Medical Economics. “The CDC estimates that 86 million adults aged 20 years or older in the U.S. have prediabetes. In many cases, type 2 diabetes can be prevented or delayed for those at high risk through a structured intervention that can be delivered cost effectively in real-world settings.”

Looking at 220 organizations with prevention programs, Ely and colleagues analyzed data from 14,747 adults who were enrolled in a year-long program from February 2012 to January 2016. Enrollment in the program entailed 16 hourly sessions held at approximately weekly intervals during the first 6 months followed by a minimum of 6 sessions held monthly for months 7 to 12. The curriculum focused on lifestyle changes and the importance of at least moderate physical activity, healthy eating and weight loss of 5% to 7% during a 1-year period.

Next: Program details

The average number of days in the program was 172, with 86.6% of participants meeting the threshold of attending four or more sessions. Overall, 35.5% of participants in the program achieved the 5% weight loss goal. The average weight loss was 4.2%. Meeting the weight loss goal was less likely in females than males, younger participants than older ones and in non-Hispanic black and participants in the “other” category compared with non-Hispanic whites (P<.0001).

The median weight loss among participants who attended at least 17 sessions for 7 to 12 months was 6.0% compared with 1.9% for those who attended 2 to 16 sessions and only remained in the program for 1 to 6 months.

“The results confirmed what we believed to be true; that the combination of program intensity and duration are important factors in achieving the desired weight loss goal of 5% to 7%,” Ely said. “Participants who remained in the program during the maintenance phase, lost more weight than those who only completed the first 6 months of the program.”

While enrolled in the program, participants reported an average of 152 minutes of physical activity each week. The physical activity goal of 150 minutes per week was met by 41.8% of participants.

For each additional session attended and for every 30 minutes of activity reported, participants lost 0.3% of body weight (P<.0001).

“The findings add to the evidence that the NIH DPP research study can be successfully translated and implemented at scale in a wide range of community settings to help reach the 86 million people with prediabetes,” Ely said.