Public Health Approaches to Type 2 Diabetes Prevention: the US National Diabetes Prevention Program and Beyond

Abstract

Purpose of review: This article highlights foundational evidence, translation studies, and current research behind type 2 diabetes prevention efforts worldwide, with focus on high-risk populations, and whole-population approaches as catalysts to global prevention.

Recent findings: Continued focus on the goals of foundational lifestyle change program trials and their global translations, and the targeting of those at highest risk through both in-person and virtual modes of program delivery, is critical. Whole-population approaches (e.g., socioeconomic policies, healthy food promotion, environmental/systems changes) and awareness raising are essential complements to efforts aimed at high-risk populations. Successful type 2 diabetes prevention strategies are being realized in the USA through the National Diabetes Prevention Program and elsewhere in the world. A multi-tiered approach involving appropriate risk targeting and whole-population efforts is essential to curb the global diabetes epidemic.

Keywords: Diabetes policy; Diabetes prevention; Diabetes prevention program; National Diabetes Prevention Program; Obesity; Type 2 diabetes.

Fig. 1

Flow chart for analysis sample. CDC = Centers for Disease Control and Prevention; DPRP = Diabetes Prevention Recognition Program; LCP = CDC-recognized lifestyle change program; National DPP = National Diabetes Prevention Program. ¹Participant eligibility was based on BMI (≥ 25 kg/m², or ≥ 23 kg/m² if Asian American), a blood test indicating prediabetes, a CDC Prediabetes Screening Test or American Diabetes Association Type 2 Diabetes Risk Test, or a previous diagnosis of gestational diabetes mellitus. ²Education level, enrollment sources, and payer sources were not collected before February 2018