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What is the National Diabetes Prevention Program?

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The CDC's National Diabetes Prevention Program (National DPP) is a structured lifestyle change program aimed at preventing or delaying the onset of type 2 diabetes among individuals at risk for disease. It is an evidence-based program developed by the Centers for Diseased Control and Prevention (CDC) in the United States and is part of the National Diabetes Prevention and Control Initiative.

 

The National DPP focuses on helping participants make sustainable, healthy lifestyle changes through the combination of:

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  • Dietary Changes: The program encourages participants to adopt a balanced and healthy diet, with emphasis on portion control, reduced calorie intake, and increased consumption of fruits and vegetables, and whole grains.

 

  • Physical Activity: It promotes regular physical activity, such as brisk walking, to increase fitness level and improve insulin sensitivity.

 

  • Coach and Group Support: Participants receive ongoing support and coaching to develop and maintain healthy behavior from the coach and fellow group-members.

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The program typically consists of structed curriculum delivered over the course of one year, with frequent sessions during the first six months and less frequency in the last six months. Participants set individualized goals and work toward achieving and maintaining a 5-7% reduction in body weight.

 

CDC Support

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The National DPP focuses on lifestyle change as the primary strategy for preventing or delaying type 2 diabetes. Hundreds of lifestyle change programs nationwide encourages sustainable changes like eating healthier, adding physical activity to the daily routine, and improving coping skills.

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  • To ensure high quality, CDC recognizes lifestyle change programs that meet certain standards and show they can achieve results. These standards include following an approved curriculum, facilitation by a trained Lifestyle Coach, and submitting data every 6 months to show that the program is having an impact.

  • The CDC National DPP has been shown to be effective in reducing the risk of type 2 diabetes in individuals with prediabetes. It has been widely implemented in community and healthcare setting across the United State and is widely covered by insurance payers, Medicare, and Medicaid. The program is part of a broader effort to combat the increasing prevalence of type 2 diabetes and its associated health complications through preventive measures.

 

The Primary Goals of the National DPP

The National DPP in the United States has several key goals aimed at reducing the risk of type 2 diabetes among individuals at high risk for the disease. The goals are aligned with the broader objective of public health and diabetes prevention. These include:

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  • Reduce Incidence. The central goal of the National DPP is to reduce the incidence of new cases of type 2 diabetes among individuals at high risk. By implementing lifestyle changes, participants are encouraged to achieve and maintain a 5 to 7% reduction in body weight which has been shown to significantly reduce diabetes risk.

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  • Support Health Equity. The program aims to ensure that participants from diverse backgrounds and communities have access to diabetes prevention programs addressing health disparities related to diabetes risk.

 

  • Promote a Healthy Lifestyle. The program aims to promote sustainable, healthy lifestyle changes among participants that extend beyond the scope of the one-year program.

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  • Improve Other Outcomes. By helping participants make healthier choices, the National DPP seeks to improve other health markers,  such as elevated blood pressure, triglycerides, and other lipids.

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  • Enhance Quality of Life. Positive lifestyle changes lead to a higher quality of life by enhancing vitality, strength, endurance, and attitude. 

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  • Empowerment. The National DPP aims to empower participants to take an active role in their health. Participants are encouraged to set and achieve personal health goals and develop self-management skills, and develop self-efficacy for long term health.

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  • Providing Support and Community Engagement. Many national DPP sessions are conducted in Group sessions fostering peer support and a sense of community. The social aspect can provide motivation and encouragement for participants to stick with their healthy habits.

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  • Reduce Healthcare Costs. By preventing or delaying the type of onset of type 2 diabetes and associated health complications, the National DPP contributes to reducing health care costs for both participants and the healthcare system.

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  • Broad Reach. The National DPP seeks to expand its reach by making the program accessible in various communities and healthcare settings, reaching as many at risk individuals as possible.

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Overall, the National DPP is designed to prevent or delay the onset of type 2 diabetes and improve the overall health and well-being of participants through education, support, and lifestyle changes. It plays a crucial role in the broader effort to combat the diabetes epidemic and its' associated health consequences.

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A Framework for Prevention

The National DPP provides a framework for diabetes prevention efforts. It brings together partners from the public and private sectors to prevent or delay type 2 diabetes in the United States. Partners include:

  • Federal agencies

  • State and local health departments

  • National and community organizations

  • Employers

  • Public and private insurers

  • Health care professionals

  • University community education programs

  • Businesses that focus on wellness

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The National DPP Lifestyle Change Program

The National DPP lifestyle change program is an evidence-based program focused on helping participants make positive lifestyle changes such as eating healthier, reducing stress, and getting more physical activity.

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Research shows that people with prediabetes who take part in this structured lifestyle change program can cut their risk of developing type 2 diabetes by 58% (71% for people over 60 years old). This is the result of the program helping people lose 5% to 7% of their body weight through healthier eating and 150 minutes of physical activity a week. For a person who weighs 200 pounds, 5% to 7% of their body weight is equivalent to 10 to 14 pounds.

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Details:

  • It is a year-long program that is delivered in person, online, or through a combination approach. The program includes at least 16 weekly sessions during the first 6 months and at least 6 monthly sessions during the second 6 months.

  • The program is taught by trained lifestyle coaches. Coaches can be health professionals or non-licensed personnel.

  • The program includes group support (recommended group size ranges between 10 and 25 participants, online groups may be larger).

  • CDC-recognized organizations offering the program can use a curriculum developed by CDC, can develop their own curriculum and submit it to CDC for approval, or can receive permission to use another organization’s curriculum as long as it is CDC approved.

  • The newly developed CDC PreventT2 Curriculum is available in both English and Spanish. The Spanish version is culturally adapted. 

  • There are thousands of CDC-recognized organizations across the 50 states and D.C. To find a program near you or to see the list of the CDC Registry of recognized organizations, click here.

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Qualification Criteria 

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The National DPP lifestyle change program is designed for people 18 years or older who have prediabetes or who are at risk for type 2 diabetes, but who do not already have type 2 diabetes. To be eligible for referral to the National DPP lifestyle change program, individuals must meet the following requirements:

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  • All of a program’s participants must be 18 years of age or older. The program is intended for adults at high risk of developing type 2 diabetes.

  • All of a program’s participants must have a body mass index (BMI) of ≥25 kg/m2 (≥23 kg/m2, if Asian American).

  • All of a program’s participants must be considered eligible based on either:

    • A blood test result within one year of participant enrollment. Blood test results may be self-reported for CDC recognition purposes. Participants enrolled in the Medicare Diabetes Prevention Program (MDPP) cannot self-report blood test results; lab results must be provided. Blood test results must meet one of the following specifications:

      • Fasting glucose of 100 to 125 mg/dl (Centers for Medicare and Medicaid Services-CMS-eligibility requirement for MDPP participants is 110 to 125 mg/dl);

      • Plasma glucose of 140 to 199 mg/dl measured 2 hours after a 75 gm glucose load;

      • HgbA1c of 5.7 to 6.4; or,

      • Clinically diagnosed gestational diabetes mellitus (GDM) during a previous pregnancy (allowed for CDC recognition and may be self-reported; not allowed for MDPP participants); or

    • A positive screening for prediabetes based on the Prediabetes Risk Test online. Note: The risk test is not an option for eligibility for MDPP participants.

  • Participants cannot have a previous diagnosis of type 1 or type 2 diabetes prior to enrollment.

  • Participants cannot be pregnant at time of enrollment.

  • A health care professional may refer potential participants to the program, but a referral is not required for participation in a CDC-recognized program.

 

To be eligible for the National DPP lifestyle change program, individuals must have one of the blood test results described above, be previously diagnosed with gestational diabetes, or score positive for prediabetes on the CDC/ADA Prediabetes Risk Test. The CDC Diabetes Prevention Recognition Program (DPRP) standards require that at least 35% of a program’s participants be diagnosed with prediabetes through blood testing (or have a history of gestational diabetes). The remaining participants in the group can be considered eligible for the program based on their scores on the CDC/ADA Prediabetes Risk Test. The CDC/ADA Prediabetes Risk Test is a brief seven question survey that allows one to gauge their risk of having prediabetes. Regularly scheduled biometric screenings may be an opportunity to determine if an individual is eligible.

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