diabetes prevention program
DESCRIPTION
Diabetes Prevention Program. Marcelle Thurston MS, RD, CDE Kelly McCracken RD, CDE Colorado Department of Public Health and Environment. Goals for Today. Define the impact of pre-diabetes in Colorado Provide an overview of the Diabetes Prevention Program (DPP) - PowerPoint PPT PresentationTRANSCRIPT
Diabetes Prevention Program
Marcelle Thurston MS, RD, CDEKelly McCracken RD, CDE
Colorado Department of Public Health and Environment
Goals for Today
• Define the impact of pre-diabetes in Colorado • Provide an overview of the Diabetes Prevention
Program (DPP)• Describe the national infrastructure in place for
DPP to be sustainable in individual states• Highlight the onsite Diabetes Prevention
Program at the Colorado Department of Public Health and Environment
• List potential roles of business coalitions
Impact of Prediabetes in Colorado
4
What is Pre-diabetes?
• A blood sugar level that is higher than normal but not high enough to be classified as diabetes
• Without lifestyle changes most people with pre-diabetes will develop type 2 diabetes within 6 years
• Risk is highest in overweight adults over the age of 45, have family history of diabetes or history of gestational diabetes
Obesity Trends* Among U.S. AdultsBRFSS, 1990
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data <10% 10%–14%
Obesity Trends* Among U.S. AdultsBRFSS, 1991
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data <10% 10%–14% 15%–19%
Obesity Trends* Among U.S. AdultsBRFSS, 1992
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data <10% 10%–14% 15%–19%
Obesity Trends* Among U.S. AdultsBRFSS, 1993
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data <10% 10%–14% 15%–19%
Obesity Trends* Among U.S. AdultsBRFSS, 1994
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data <10% 10%–14% 15%–19%
Obesity Trends* Among U.S. AdultsBRFSS, 1995
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data <10% 10%–14% 15%–19%
Obesity Trends* Among U.S. AdultsBRFSS, 1996
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data <10% 10%–14% 15%–19%
Obesity Trends* Among U.S. AdultsBRFSS, 1997
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data <10% 10%–14% 15%–19% ≥20%
Obesity Trends* Among U.S. AdultsBRFSS, 1998
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data <10% 10%–14% 15%–19% ≥20%
Obesity Trends* Among U.S. AdultsBRFSS, 1999
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data <10% 10%–14% 15%–19% ≥20%
Obesity Trends* Among U.S. AdultsBRFSS, 2000
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data <10% 10%–14% 15%–19% ≥20%
Obesity Trends* Among U.S. AdultsBRFSS, 2001
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data <10% 10%–14% 15%–19% 20%–24% ≥25%
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
Obesity Trends* Among U.S. AdultsBRFSS, 2002
No Data <10% 10%–14% 15%–19% 20%–24% ≥25%
Obesity Trends* Among U.S. AdultsBRFSS, 2003
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data <10% 10%–14% 15%–19% 20%–24% ≥25%
Obesity Trends* Among U.S. AdultsBRFSS, 2004
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data <10% 10%–14% 15%–19% 20%–24% ≥25%
Obesity Trends* Among U.S. AdultsBRFSS, 2005
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%
Obesity Trends* Among U.S. AdultsBRFSS, 2006
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%
Obesity Trends* Among U.S. AdultsBRFSS, 2007
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%
Obesity Trends* Among U.S. AdultsBRFSS, 2008
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%
Obesity Trends* Among U.S. AdultsBRFSS, 2009
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%
Obesity Trends* Among U.S. AdultsBRFSS, 2010
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%
26 million with Diabetes
79 millionwith Prediabetes
Value of Investing in PreventionDelaying or preventing diabetes impacts:
Presenteeism Productivity Staff retention
Mitigates higher risk pool: Avg. medical costs for a person with diabetes are
nearly twice those of a person without diabetes Costs are more than four-fold for a person with
diabetes-related complications compared to a person without diabetes
No diabetes Prediabetes Diabetes, no complications Diabetes, compliant w/ hypertension
Diabetes, compliant w/ CVD$0
$2,000
$4,000
$6,000
$8,000
$10,000
$12,000
$14,000
Total Progressive Cost for Diabetes($/per member per year; average for 2 large health plans; excludes Rx)
Overview of the Diabetes Prevention Program (DPP)
30
The Diabetes Prevention Program (DPP)
• Based on NIH and CDC clinical trials• 5% - 7% weight loss & increased physical
activity to 150 minutes a week reduced risk of developing type 2 diabetes by 58%
• 10-year follow up study showed reduced diabetes incidence of 34% in the lifestyle group
• Translated into 16-week group based program
Cardiovascular risk factors also improved with the DPP
• Blood pressure significantly lowered
• Cholesterol levels significantly improved
• At 3 year follow-up the use of meds for both blood pressure and cholesterol were lowered
DPP. Diabetes Care 28:888–894, 2005
Journey of the Diabetes Prevention Program
Clinical research trials
funded throughNIH and CDC
DPP was adapted for
groups based classes
YUSA was an early adopter of the DPP
(YDPP)
UnitedHealthGroupwas an early adopter
of the DPP
(DPCA)
To date the YDPP is in 39 states
Participating YMCA’s are reimbursed by
United
CDC developed the Diabetes
Prevention Recognition
Program
The Diabetes and Technical
Assistance Center developed a
training for the curriculum
CDC , through their state-based Diabetes
Prevention and Control Programs, are promoting the
DPP
Colorado’s DPP Advisory Group
CDC
How DPP differs from other programs
• Evidence based• Low cost• Pay for performance model• Decreases risk of other obesity related
diseases• National infrastructure to assure fidelity
The look of DPP
• 16-week group based classes• Led by a skilled facilitator• Topics include healthy eating, physical activity, goal
setting• Offered at YMCA and community based organizations
in several counties• Can be offered onsite for employees• UnitedHealthcare covers DPP in CO for fully-insured
members• $300-$400 per participant; based on outcomes
Role of Business Coalitions• Educate employers about pre-diabetes and Diabetes
Prevention Programs in the area1-800-DIABETES
• Support employers in identifying:– % of employees at risk– communication strategies about prediabetes and DPP– community partners
• Align shared priorities and goals • Create tip sheet for how to negotiate with health
plans to include the Diabetes Prevention Program
38
For more information
CDC Diabetes Prevention and Recognition Program
http://www.cdc.gov/diabetes/prevention/recognition/index.htm
Kelly [email protected]
303/692.2512
Marcelle [email protected]
303/692.2519