Frontline Account: Resident-led Implementation of the National Diabetes Prevention Program within Primary Care Clinics of a Large, Academic Medical Center

Autor: Dina Hafez, Mariana L De Michele, Namita Sachdev
Rok vydání: 2016
Předmět:
Zdroj: Journal of General Internal Medicine. 31:573-575
ISSN: 1525-1497
0884-8734
DOI: 10.1007/s11606-016-3613-6
Popis: Mr. P is one of an approximate 86 million U.S. adults with prediabetes, an asymptomatic condition that portends an increased risk of developing type 2 diabetes. Despite the high prevalence of prediabetes, the Centers for Disease Control and Prevention (CDC) estimate that 90 % of prediabetic individuals are not aware that they have the condition. This is an undeniable public health threat, as 5–10 % of these individuals, if untreated, will progress annually to diabetes. Fortunately, it is possible to prevent or delay the onset of diabetes by identifying at-risk individuals and engaging them in evidence-based interventions. The landmark Diabetes Prevention Program Trial showed a reduction in the 3-year incidence of diabetes with either modest behavior change or metformin compared to placebo. Specifically, 7 % body weight loss and increased physical activity led to a 58 % reduction in diabetes while treatment with metformin resulted in a 31 % decrease in disease incidence. These results have generated nationwide efforts to translate dietary and physical activity interventions into clinical practice. The CDC designed the National Diabetes Prevention Program (NDPP), a 22-week, groupbased adaptation of the trial’s lifestyle interventions. Trained coaches deliver education on diet and exercise and record participant weights and physical activity minutes. While the program has been successfully administered in a variety of clinical and community settings, the YMCA, in partnership with UnitedHealth Group, has led one of the most extensive implementation initiatives. During a 2-year period, more than 1700 individuals completed the YMCA’s program and achieved an average weight loss of 5 %, showing that program can be both effective and scalable in a real-world setting.
Databáze: OpenAIRE
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