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. 2022 Oct;63(4):603-610.
doi: 10.1016/j.amepre.2022.04.002. Epub 2022 Jun 16.

Use and Impact of Type 2 Diabetes Prevention Interventions

Joanne R Campione  1 , Natalie D Ritchie  2 , Howard A Fishbein  3 , Russell E Mardon  3 , Maurice C Johnson Jr  3 , Wilson Pace  4 , Rebecca Jeffries Birch  3 , Eileen L Seeholzer  5 , Xuanping Zhang  6 , Krista Proia  6 , Karen R Siegel  6 , Kai McKeever Bullard  6
Affiliations

Use and Impact of Type 2 Diabetes Prevention Interventions

Joanne R Campione et al. Am J Prev Med. 2022 Oct.

Abstract

Introduction: RCTs have found that type 2 diabetes can be prevented among high-risk individuals by metformin medication and evidence-based lifestyle change programs. The purpose of this study is to estimate the use of interventions to prevent type 2 diabetes in real-world clinical practice settings and determine the impact on diabetes-related clinical outcomes.

Methods: The analysis performed in 2020 used 2010‒2018 electronic health record data from 69,434 patients aged ≥18 years at high risk for type 2 diabetes in 2 health systems. The use and impact of prescribed metformin, lifestyle change program, bariatric surgery, and combinations of the 3 were examined. A subanalysis was performed to examine uptake and retention among patients referred to the National Diabetes Prevention Program.

Results: Mean HbA1c values declined from before to after intervention for patients who were prescribed metformin (-0.067%; p<0.001) or had bariatric surgery (-0.318%; p<0.001). Among patients referred to the National Diabetes Prevention Program lifestyle change program, the type 2 diabetes postintervention incidence proportion was 14.0% for nonattendees, 12.8% for some attendance, and 7.5% for those who attended ≥4 sessions (p<0.001). Among referred patients to the National Diabetes Prevention Program lifestyle change program, uptake was low (13% for 1‒3 sessions, 15% for ≥4 sessions), especially among males and Hispanic patients.

Conclusions: Findings suggest that metformin and bariatric surgery may improve HbA1c levels and that participation in the National Diabetes Prevention Program may reduce type 2 diabetes incidence. Efforts to increase the use of these interventions may have positive impacts on diabetes-related health outcomes.

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