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U.S. Diabetes Prevention Program Might Avert 885,000 Cases

January 13, 2012

THURSDAY, Jan. 12 (HealthDay News) — A national community-based
diabetes prevention program in the United States could prevent or delay
885,000 cases of type 2 diabetes over 25 years, a new federal government
study says.

Overall, the program would save $29.8 billion in medical costs. But,
the program itself would require a $24 billion investment. Still, the
researchers said, it would only take about 14 years to recoup the money
spent on the program.

“The take-home message is that implementing screening and
community-based lifestyle interventions can improve health and reduce
health care costs over the long term. This is an efficient use of health
care resources,” said Xiaohui Zhuo, a health economist in the division of
diabetes translation at the U.S. Centers for Disease Control and

Findings from Zhuo’s study are published in the January issue of
Health Affairs, a thematic issue of the journal looking at diabetes
prevention programs.

Almost 26 million Americans have type 2 diabetes, according to the CDC.
The exact cause of the disease is unknown, but lifestyle factors such as
being overweight or not exercising are strongly associated with the
development of type 2 diabetes. People diagnosed with prediabetes can
often prevent the development of type 2 diabetes by losing some weight and
increasing their physical activity. The American Diabetes Association
recommends at least 150 minutes of moderate aerobic activity each week.

According to the new study, everyone in the country between 65 and 84
would receive a letter offering laboratory screening for diabetes. The
researchers assumed that younger people would be screened at their
physicians’ offices.

Zhuo’s hypothetical lifestyle program is a community-based intervention
based on the “Promoting a Lifestyle of Activity and Nutrition for Working
to Alter the Risk of Diabetes” study. The program would include 16
intensive core sessions offered over five months to help people lose
weight and to adopt other healthy lifestyle habits. The researchers
estimated a weight loss of about nine pounds.

The first sessions would be followed by six monthly sessions to help
reinforce and sustain the new lifestyle changes. During the second year,
people would be offered eight maintenance sessions.

During the first- and second-year sessions, the training would be
offered by trained lifestyle coaches. Next, follow-up sessions would be
conducted by a health care provider once or twice a year, according to the

Realizing that not everyone would maintain a weight loss or a new
exercise regimen, the authors assumed that there would be a 40 percent
risk reduction in diabetes for the first two years for people between 18
and 64. They also assumed that after the first two years, there would be a
decrease in the risk reduction of about 10 percent per year.

Zhuo and colleagues also assumed that older people might be more likely
to sustain healthy changes and figured a 50 percent reduction in diabetes
risk for the first two years and a 15 percent decline in risk reduction
for each subsequent year in people between 65 and 84 years old.

The cost of this intervention would be about $300 per person for the
first year, $150 for the second and about $50 a year thereafter, according
to the report. The authors estimated it would take about 14 years to
recoup this investment. But, over 25 years, it would save nearly $6
billion in health care costs.

Zhuo said the biggest barrier to implementing such a program would be
funding. But, he said, policies offering incentives to private insurers
for providing diabetes-prevention reimbursement might help get more
insurers to consider making the investment.

Some insurers are onboard with the concept of prevention programs. In
another article in the same issue of the journal, Deneen Vojta, chief
clinical officer for the UnitedHealth Diabetes Prevention and Control
Alliance, reviewed different strategies that may help stem the rising tide
of type 2 diabetes. These ideas include encouraging lifestyle changes,
developing partnerships with pharmacists, nurses and health coaches, and
implementing new programs for Medicare and Medicaid to help patients make
lifestyle changes.

“This is a problem the whole world is facing. It’s the concept of
changing the paradigm and shifting the focus from treatment to
prevention,” said Dr. Joel Zonszein, director of the clinical diabetes
center at Montefiore Medical Center in New York City.

“Prevention is cheaper and investments in health do save in the long
term. But, who’s going to sponsor it?” he asked.

Zonszein said it’s also critically important that any diabetes program
and education be tailored to the specific population. That means what
works in a wealthy suburban setting probably won’t be helpful in a poorer
inner-city area and vice versa. “Diet and exercise programs have to be
individually tailored,” he said.

More information

See if you’re at risk for type 2 diabetes by visiting the American Diabetes Association.

Article source: http://news.yahoo.com/u-diabetes-prevention-program-might-avert-885-000-190427216.html


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