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Comment
. 2017 Oct;40(10):1298-1301.
doi: 10.2337/dci17-0012.

From Programs to Policy and Back Again: The Push and Pull of Realizing Type 2 Diabetes Prevention on a National Scale

Ronald T Ackermann  1
Affiliations
Comment

From Programs to Policy and Back Again: The Push and Pull of Realizing Type 2 Diabetes Prevention on a National Scale

Ronald T Ackermann. Diabetes Care. 2017 Oct.
No abstract available

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Figures

Figure 1
Figure 1
Estimates for reach and population-level effectiveness of the National DPP under status quo and with alignment of health sector policies to increase identification and participation. *From the CDC report (2013) that 11.1% of U.S. adults with prediabetes are aware that they have it (3); by contrast, 62% of adults report having been tested for (and are aware of having) high LDL cholesterol (25,26). †There are no population estimates of the “linkage rate” to National DPP for screen-detected adults with prediabetes; by contrast, linkage to high-intensity treatment for abnormal blood cholesterol is about 70% of identified high-risk patients (25,26). ‡Current National DPP enrollment to date estimated from program growth as provided by Ely et al. (5); prior community effectiveness trials have demonstrated participation by 30–50% of adults referred to community DPP interventions after being made aware that they have prediabetes (6). §See text for details; assumes 18.4% of adults with prediabetes identified by HbA1c will have type 2 diabetes in 10 years (17), 5% weight loss via the National DPP is associated with a 58% reduction in the development of type 2 diabetes (18), and 35% of National DPP participants reach ≥5% weight loss (5).
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References

    1. Centers for Disease Control and Prevention. National Diabetes Statistics Report, 2017: Estimates of Diabetes and Its Burden in the United States [Internet]. U.S. Department of Health and Human Services, 2017. Available from https://www.cdc.gov/diabetes/pdfs/data/statistics/national-diabetes-stat.... Accessed 30 July 2017
    1. Balk EM, Earley A, Raman G, Avendano EA, Pittas AG, Remington PL. Combined diet and physical activity promotion programs to prevent type 2 diabetes among persons at increased risk: a systematic review for the Community Preventive Services Task Force. Ann Intern Med 2015;163:437–451 - PMC - PubMed
    1. Centers for Disease Control and Prevention (CDC) Awareness of prediabetes--United States, 2005-2010. MMWR Morb Mortal Wkly Rep 2013;62:209–212 - PMC - PubMed
    1. Centers for Disease Control and Prevention. National Diabetes Prevention Program [Internet]. U.S. Department of Health and Human Services. Available from https://www.cdc.gov/diabetes/prevention/index.html. Accessed 7 April 2017
    1. Ely EK, Gruss SM, Luman ET, et al. . A national effort to prevent type 2 diabetes: participant-level evaluation of CDC’s National Diabetes Prevention Program. Diabetes Care 2017;40:1331–1341 - PMC - PubMed

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