Just 2.4% of adults with probably prediabetes are participating in diabetes prevention programs, according to 2016 NHIS – February 19, 2019

4.2% of eligible adults were referred (~40% of those referred didn’t participate); black and Asian adults more likely to be referred, below fed poverty level more likely to participate

A study recently published in the American Journal of Preventive Medicine found that, of 2,341 eligible adults with probable prediabetes and no self-reported diagnosis of diabetes, only 4.2% were referred to and 2.4% actually participated in a 12-month diabetes prevention program (DPP). The data was pulled from diabetes primary prevention-related questions on the annual National Health Interview Survey (NHIS).  

Albeit from a small sample, the survey did unearth a couple of interesting socio-demographic trends: black and Asian adults were more likely than other races to report referral; individuals below the federal poverty level, ages 65+, and of multiple races were more likely to report participation. In addition, interest in participation among those who had never been referred nor participated was a fairly high 26%. These data, taken together, point to encouraging trends: Groups who are disproportionately affected by diabetes seem to be more likely to be referred, and there is no shortage of interest in participating.

If generalizable, the numbers suggest that ~two million of the 84 million Americans with prediabetes have already participated in a DPP (which admittedly sounds high to us), an additional ~20 million may be interested, and ~40% of people who are referred don’t participate. CDC’s Dr. Ann Albright’s AADE (July) update suggested that National DPP enrollment was up to 235,000. As of the 2016 NHIS – prior to the 2018 implementation of the Medicare DPP – eligible Medicare beneficiaries made up just 2% of those referred and 12% of those who participated in a DPP. That number has likely seen an uptick in 2018 and into 2019.

Finally, the fact that there exists significant demand for participation in a DPP lends itself to, firstly, more HCP education about DPPs, and secondly, greater utilization of (and reimbursement for) virtual DPPs. Lark recently became the 12th provider to join the ranks of virtual DPP providers with full CDC recognition (five others have preliminary recognition status). What will it take for these providers to see greater referrals and participation?

-- by Peninah Benjamin, Brian Levine, and Kelly Close