With more than 34 million Americans diagnosed with diabetes, most people know someone watching their blood sugar. Many people acknowledge there are two types of diabetes: Type 1 diabetes or the “bad one” (bad because you have to inject insulin and stick your fingers everyday); and Type 2 diabetes or the “other one” (where you take a pill). Most people believe having diabetes is not a good thing because you aren’t suppose to “eat sugar”. Many believe diabetes can cause bad things. The bad things or complications include:
- Blindness
- Cardiovascular disease and stroke
- Kidney disease
- Non-healing wounds and non-traumatic amputations
While research for a cure to Type 1 diabetes continues, it is estimated 9 out of 10 diagnoses of Type 2 diabetes could be prevented. Earlier research demonstrated that persons with Type 2 Diabetes (T2DM) typically present with signs of increased risk years before receiving a diagnosis. This time prior to Type 2 diagnosis became known as pre-diabetes. A simple set of questions can determine “Are You at Risk” of T2DM. If results show a score of five or higher, then that person could be a candidate for diabetes prevention.
In 2010 the National Diabetes Prevention Program (NDPP) was created to prevent Type 2 diabetes. The NDPP is a research-based program largely focused on healthy eating and physical activity to reduce a person’s risk of developing T2DM. It is managed by the Centers for Disease Control and Prevention (CDC). The results are impressive: 58% reduction in risk of developing T2DM; 71% reduction in risk for persons 60 years of age or older.
How does the NDPP do it?
- Programs that offer the official NDPP program are partners with the NDPP (CDC) and include public and private organizations.
- NDPP partner programs may include health care professionals or lay persons associated with community groups.
- Partner program staff have all received formal training in NDPP standards and the lifestyle change curriculum
- The goal of NDPP partner programs is to become “recognized” by the NDPP. Recognition means the program has met quality and adherence standards and achieved expected levels of success in participants. These standards include following an approved curriculum, facilitation by a trained lifestyle coach, and submitting data every 6 months to the NDPP demonstrating the program is having a positive impact on prevention by meeting therapy goals.
- Recognized programs are eligible to receive Medicare reimbursement. While working toward full recognition status, many programs receive reimbursement via commercial health insurance policies, employer coverage, and/or participant self-pay.
- All recognized programs use CDC recognized curriculum. The curriculum is provided through classes over 12 months — it takes time to change a lifetime of habits.
- The first 6 months participants meet weekly for an hour learning about meal planning, physical activity, barriers, and coping with challenges. A partial topic list includes:
- Three Ways to Eat Less Fat and Fewer Calories
- Move Those Muscles
- Tip the Calorie Balance
- Take Charge of What’s Around You
- Problem Solving Four Keys to Healthy Eating Out
- Talk Back to Negative Thoughts
- The Slippery Slope of Lifestyle Change
- Jump Start Your Activity Plan
- Make Social Cues Work for You
- You Can Manage Stress
- Ways to Stay Motivated
- The second six months participants meet monthly building on earlier skills learned and receiving continual support. The goal is a long term lifestyle change supporting the reduction of Type 2 diabetes risk. A partial topic list includes:
- Fats – Saturated, Unsaturated, and Trans Fat
- Food Preparation and Recipe Modification
- Healthy Eating – Taking it One Meal at a Time
- Healthy Eating with Variety and Balance
- More Volume, Fewer Calories
- Balance Your Thoughts for Long-Term Maintenance
- Handling Holidays, Vacations, and Special Events
- Preventing Relapse
- Stress and Time Management
- Heart Health
- A Closer Look at Type 2 Diabetes
- Looking Back and Looking Forward
- The first 6 months participants meet weekly for an hour learning about meal planning, physical activity, barriers, and coping with challenges. A partial topic list includes:
- NDPP partners may offer their service via face-to-face class meetings or online including emails, text messages, and live video classes or a combination of the above.
The Lifestyle Change Program is the core component to the NDPP’s diabetes prevention. It is a guided journey through the skills necessary to make the behavior changes to reduce T2DM risk and prevention. The Curriculum includes instructor manual for implementation and suggested ideas to keep the classes educational, entertaining, and progressing in a positive direction.
For the participant there is an easy reading manual of lessons complete with handouts to support developing skills and preparation for behavior change challenges. Lessons are made available to participants as the classes progress. The plan is to introduce behavior change strategies gradually and allow participants opportunities to practice new behaviors before introducing new strategies.
While the Lifestyle Change Program curriculum is the backbone of the classes, instructors are not discouraged from extras like cooking demonstrations and/or field trips to the supermarket, public walking areas, or sports stores. Some programs schedule regular exercise programs around class times and/or include fitness gym memberships to participants.
The atmosphere is casual and frequently participants elect to continue on in a maintenance support group after completion of the curriculum. It should be noted that Medicare recognizes an additional 12 months of ongoing maintenance sessions if you meet certain weight loss and attendance goals during the initial 12-month curriculum.
With approximately 2,000 Recognized Diabetes Prevention Program providers across the United States, there’s probably one near you. Remember virtual Diabetes Prevention Programs (Online or Distance Learning programs) can easily cross the miles via the internet to meet your needs and comply with social distancing requirements. Go to the Registry of All Recognized Organizations to see a full list of CDC-Recognized programs. Don’t hesitate to reach out to a diabetes prevention site that meets your needs: In-person, distance learning, online or some combination of the three.
So take the test and know the risk. Is diabetes prevention in your future? Consider that a diabetes prevention program follow-up study demonstrated participants were still one-third less likely to develop Type 2 diabetes ten years after the successful completion of the 12-month Lifestyle Change program. Those participants who developed diabetes were successful in delaying a Type 2 diabetes diagnosis about four years. This November celebrate National Diabetes Month and commit to reducing your risk of Type 2 diabetes.