For this month’s blog, I wanted to highlight and briefly talk about the CDC’s National Diabetes Prevention Program (NDPP). I have had the pleasure to facilitate this program as a lifestyle health coach. My personal feedback and experience is that the program works. I saw individuals not only meet their health goals but they met them with a very positive attitude. It was refreshing and exciting to see. I share this in hopes that our state continues to grow accredited programs and help individuals that are at high risk of type 2 diabetes to cut their risk in half.
What is the NDPP?
The NDPP is a national initiative targeting all communities across the United States. The Department of Health (DOH), in each state, also has their own initiative in implementing the NDPP in communities. The program maintains a national registry of all NDPP that are recognized as being an accredited program and for effective delivery of lifestyle change intervention programs to prevent type 2 diabetes (CDC National Diabetes Prevention Program, 2018).
The stated mission of the NDPP is “to encourage collaboration among federal agencies, community-based organizations, employers, insurers, health care professionals, academia, and other stakeholders to prevent or delay the onset of type 2 diabetes among people with prediabetes in the United States”(CDC National Diabetes Prevention Program, 2018).
The CDC has a Prediabetes Screening Test tool that is used to help identify those individuals that are at high risk for developing type 2 diabetes. The tool was created to help healthcare professionals identify individuals that fit the criteria to benefit from the Diabetes NDPP. Once an individual is screened and identified as being at risk for type 2 diabetes they can then be referred to an NDPP (CDC Prediabetes Screening Test, 2018).
One of the primary goals of the NDPP is to make it easier for individuals with prediabetes to partake in inexpensive, high-quality lifestyle change programs to minimize their risk for developing type 2 diabetes and also to improve their general health. Individuals have busy and complicated lives, which is why the NDPP aims to accommodate for this and to make things feasible with the program. The NDPP can be attended in person or online. Having an online option helps to increase accessibility to the program for those that live in rural areas or that do not have an accredited NDPP site near them (CDC National Diabetes Prevention Program, 2018).
The main outcome goal of the program is to cut diabetes risk in half by achieving weight loss and physical activity goals. The weight loss goal for the program is to lose 7% of the starting weight at the beginning of the program and to get in at least 150 minutes of physical activity a day. The program outlines strategies on a weekly basis to help participants individualize their plan to achieve these goals (CDC National Diabetes Prevention Program, 2018).
This lifestyle change program is not a fad diet nor an exercise class. Also, it is not a quick fix. It is a year-long program focused on long-term changes and lasting results. During the first six months of the program, individuals meet once a week and during the second six months of the program individuals meet once or twice a month. There are three key components to the program which include: CDC-approved curriculum with lessons and handouts, a lifestyle coach, and a support group of people. A trained lifestyle coach leads the program to help individuals change certain aspects of their lifestyle, like eating healthier, reducing stress, and getting more physical activity. The program also includes group support from others who share similar goals and struggles. Individuals in the program will learn to make healthier meals by including lots of vegetables, watching portion sizes, and reducing calories. The calorie reduction is focused on watching fat intake rather than a low carbohydrate diet that is commonly seen in fad diets. The reason behind this is that fat yields the highest number of calories versus carbohydrates which yield the same as protein. Cutting down on high-fat foods will reduce the total daily calorie amount more drastically than focusing on cutting out carbohydrates (CDC National Diabetes Prevention Program, 2018).
During the first half of the program, individuals will learn to: eat healthy without giving up all the foods that they love, add physical activity to daily life even if there does not seem to be time to do so, cope with stress, deal with challenges that can derail hard work, and get back on track if an individual stray from their individualized plan (CDC National Diabetes Prevention Program, 2018).
In the second half of the program individuals learn how to enhance the skills that they developed in the first six months in order to help them to maintain the changes have accomplished. The sessions in the second half of the program will review key ideas, including: tracking food and physical activity, setting goals, staying motivated, and overcoming barriers (CDC National Diabetes Prevention Program, 2018).
To ensure high quality, CDC recognizes lifestyle change programs that meet certain standards and show they can achieve results. These standards include following the approved curriculum described above, facilitation by a trained lifestyle coach, and submitting data every six months to show that the program is having an impact (CDC National Diabetes Prevention Program, 2018).
The CDC funds the program through six organizations in order to reach the most people who are at high risk for diabetes, including: The American Association for Diabetes Educators, America's Health Insurance Plans, Black Women's Health Imperative, National Association of Chronic Disease Directors, OptumHealth Care Solutions, and YMCA of the USA. Funded organizations will offer the program, provide information to employers about offering the program, and work with third-party payers to facilitate performance-based reimbursement directly to organization delivering the lifestyle change program (CDC National Diabetes Prevention Program, 2018).
Through the NDPP, partner organizations: deliver CDC-recognized lifestyle change programs nationwide, ensure quality and adherence to proven standards, train community organizations that can run the lifestyle change program effectively, increase referrals to and participation in CDC-recognized lifestyle change programs, and increase coverage by employers and public and private insurers (CDC National Diabetes Prevention Program, 2018).
I highly encourage everyone to check out the resource links below and refer your patients that are at high risk of type 2 diabetes to a NDPP in New Mexico.
Resources
References
Ackermann, R. T. (2017). From Programs to Policy and Back Again: The Push and Pull of Realizing Type 2 Diabetes Prevention on a National Scale. Diabetes Care, 40(10), 1298-1301. doi:10.2337/dci17-0012
CDC Prediabetes Screening Test. (2018). Retrieved from https://www.cdc.gov/diabetes/prevention/pdf/prediabetestest.pdf
CDC National Diabetes Prevention Program. (2018). Retrieved from https://www.cdc.gov/diabetes/prevention/index.html
Christophi, C., Resnick, H., Ratner, R., Temprosa, M., Fowler, S., Knowler, W., & ... Kahn, S. (2013). Confirming Glycemic Status in the Diabetes Prevention Program: Implications for Diagnosing Diabetes in High Risk Adults. Journal Of Diabetes And Its Complications, 27150-157. doi:10.1016/j.jdiacomp.2012.09.012
Diabetes Prevention Program Research Group. (2009). 10-year follow-up of diabetes incidence and weight loss in the Diabetes Prevention Program Outcomes Study. Lancet, 374(9702), 1677–1686. http://doi.org/10.1016/S0140-6736(09)61457-4
Ely, E. K., Gruss, S. M., Luman, E. T., Gregg, E. W., Ali, M. K., Nhim, K., & ... Albright, A. L. (2017). A National Effort to Prevent Type 2 Diabetes: Participant-Level Evaluation of CDC's National Diabetes Prevention Program. Diabetes Care, 40(10), 1331-1341. doi:10.2337/dc16-2099
Mensa-Wilmot, Y., Bowen, S., Rutledge, S., Morgan, J. M., Bonner, T., Farris, K., & ... Rutledge, G. (2017). Early Results of States' Efforts to Support, Scale, and Sustain the National Diabetes Prevention Program. Preventing Chronic Disease, 141-7. doi:10.5888/pcd14.170478
Subramanian, K., Midha, I., & Chellapilla, V. (2017). Overcoming the Challenges in Implementing Type 2 Diabetes Mellitus Prevention Programs Can Decrease the Burden on Healthcare Costs in the United States. Journal Of Diabetes Research, 1-5. doi:10.1155/2017/2615681
2020 Topics & Objectives. (2018, May 09). Retrieved from https://www.healthypeople.gov/2020/topics-objectives/topic/diabetes