Number and Characteristics of US Adults Meeting Prediabetes Criteria for Diabetes Prevention Programs: NHANES 2007–2016

Excerpt

Type 2 diabetes is a major public health challenge but can be prevented. The landmark Diabetes Prevention Program (DPP) Trial demonstrated a 58% reduction in 3-year diabetes incidence with an intensive lifestyle intervention in high-risk persons with prediabetes.¹ There is substantial interest in translating this program to community settings. In 2010, the Centers for Disease Control and Prevention created a partnership called the National Diabetes Prevention Program (National DPP) and developed a set of guidance documents and steps for national certification of local lifestyle change programs.² In 2018, the Centers for Medicare and Medicaid Services began providing insurance coverage for Medicare beneficiaries meeting Medicare DPP criteria to attend recognized DPPs.³ As is typical for research translation, community-based programs that are part of the National DPP use less restrictive eligibility criteria than the original DPP Trial. The Medicare DPP model was certified based on expected Medicare savings.⁴ Differences in eligibility criteria may influence the effectiveness of the intervention and the potential influence on the diabetes epidemic. Currently, it is unknown how many adults in the USA are eligible for these programs. By each set of criteria, we sought to quantify (1) the proportion and number of US adults who would be eligible and (2) the differences in characteristics of adults identified. …