Healthy Interactions is now a recognized organization* for the Centers of Disease Control’s (CDC) Diabetes Prevention Program. And two weeks ago, CMS proposed a prediabetes prevention program expansion and reimbursement that is expected to be approved by the end of 2016. Clearly, the war on diabetes is intensifying.

The US currently has over 29 million people living with diabetes and 86 million with prediabetes, making it a count of one in three adults.  Unfortunately, nine out of 10 adults with prediabetes don’t even know they have it.  

Prediabetes is a reversible cardiometabolic risk factor with a A1c result between 5.7 and 6.4% and 100 to 125 mg/dL (5.6 to 6.9 mmol/L). Evidence-based National Diabetes Prevention Program (National DPP) funded a 3-arm Randomized Control Trial with placebo, Metformin and intensive lifestyle coaching indicated that 5-7% body weight loss reduced the risk of developing Type 2 diabetes by 58% in those with prediabetes (over three years) and 71% in those over age 60.

The CDC approved, evidence-based DPP aims to slow and prevent the development of type 2 diabetes by:

• Lay and health professional lifestyle coaches teach in-person or virtual group classes of 8-15 participants
• Comprehensive program focused on weight loss through exercise, healthy eating, and behavior modification
• 16 weekly sessions
• Core phase (six months)
• Maintenance phase (six months) with monthly maintenance sessions

Examples of topics covered in core curriculum include: balancing calories, strategies for healthy eating out, problem solving/coping, social cues, overcoming physical activity barriers, and managing stress.

Offering the National DPP helps achieve better clinical and financial results over three years. Based on the outcomes from DPP research studies reaching 100 adults with prediabetes:

• 58% reduction in incidence of diabetes
• 25% reduction in medication use for hypertension and hyperlipidemia
• 1-2% reduction in absenteeism (missed work days) and productivity loss

Potential cost savings from offering the DPP with avoidable cost of  $2,470 for first year, $3,190 for second and $2,350 for a third year.

As an intervention to prevent diabetes, the National DPP costs an average of $450 per participant for a year. Alternatively, Diabetes costs approximately $2,700 per individual with newly diagnosed diabetes in the first year of treatment^. Individuals with prediabetes have a 15% to 30% chance of developing type 2 diabetes within five years^.

The next step is to advance the DPP to advance program efficiency with increased productivity and reduced absenteeism.  Healthy Interactions is now involved in the CDC recognition program as we want to be a part of solution to ensure program quality and fidelity.  The national goals are to increase participant completion rate, engage participants throughout the program, help physicians to discuss the program with their patients, align costs to outcomes, design effective deployment models and explore outcomes-based payment models.

We are very excited to use our Conversation Map methodology to deploy DPP that is a part of being proactive about diabetes.   Looking forward to collaborating with our health care provider network to creating a national standard in diabetes prevention approaches.

*Healthy Interactions has received “pending recognition” as a provider of the Centers for Disease Control and Prevention’s (CDC) National Diabetes Prevention Program (NDPP). This pending recognition indicates that Healthy Interactions is on a track to accomplish the performance criteria detailed in the CDC’s Diabetes Prevention Recognition Program and to effectively deliver a proven type 2 diabetes prevention lifestyle intervention. In accordance with the NDPP guidelines, Healthy Interactions will receive “full recognition” after completing the two-year “pending” standard. 

Sources:

Knowler WC, Barrett-Connor E, Fowler SE, et al. Diabetes Prevention Program Research Group. Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N Engl J Med. 2002;346(6):393-403.

Dall, Timothy M., et al. “Value of Lifestyle Intervention to Prevent Diabetes and Sequelae.” American journal of preventive medicine 48.3 (2015): 271-280.

Ratner R, Goldberg R, Haffner S, et al. Impact of intensive lifestyle and metformin therapy on cardiovascular disease risk factors in the diabetes prevention program. Diabetes Care. 2005;28(4):888- 894.

Potential cost savings from offering the DPP with avoidable cost: 2009-2012 individual level data from the Truven Health MarketScan® Lab Database - a 4.4 million subsample of the Truven Health MarketScan® Treatment Pathways. MarketScan is a registered trademark of Truven Health Analytics Inc.

Centers for Disease Control and Prevention. National Diabetes Statistics Report: Estimates of Diabetes and Its Burden in the United States, 2014. Atlanta, GA; 2014. Available at: http://www.cdc.gov/diabetes/pubs/statsreport14/national-diabetes-report-web.pdf