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Review
. 2020 Aug 19:13:2949-2957.
doi: 10.2147/DMSO.S218334. eCollection 2020.

Current Perspectives on the Impact of the National Diabetes Prevention Program: Building on Successes and Overcoming Challenges

Natalie D Ritchie  1   2   3 , Katherine J W Baucom  4 , Katherine A Sauder  5   6
Affiliations
Review

Current Perspectives on the Impact of the National Diabetes Prevention Program: Building on Successes and Overcoming Challenges

Natalie D Ritchie et al. Diabetes Metab Syndr Obes. .

Abstract

To address the public health and economic burden of type 2 diabetes, the Centers for Disease Control and Prevention (CDC) began dissemination of the National Diabetes Prevention Program (NDPP) in the United States in 2010. Based on the intensive lifestyle intervention from a large efficacy trial, the NDPP aims to reduce incidence through lifestyle change and weight loss. This narrative review summarizes evidence on reach, effectiveness, and sustainability of the NDPP, while highlighting opportunities to overcome challenges in these areas. Major successes include reaching hundreds of thousands of at-risk individuals across the nation, with notable effectiveness upon full participation and widespread insurance coverage. Yet, more work is needed to ensure greater public health impact, particularly among priority populations at heightened risk who also experience disparities in program outcomes. Preliminary evidence suggests a number of strategies may improve reach and effectiveness of the NDPP, often with more rigorous study needed prior to widespread uptake. Updating the NDPP to better match the current evidence-base may also be important, such as directly targeting glycemia with a patient-centered approach and promoting metformin as an adjunct or second-line treatment. Finally, revisiting pay-for-performance reimbursement models may be critical to sustainability by ensuring adequate availability of suppliers and ultimately reducing diabetes prevalence.

Keywords: lifestyle modification; obesity; prediabetes; prevention; type 2 diabetes mellitus.

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Conflict of interest statement

NDR has received past and present grant support from the Centers for Disease Control and Prevention for work related to the National Diabetes Prevention Program, and grants from National Institutes of Health, during the conduct of the study. The authors report no other conflicts of interest in this work.

References

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