Few American adults at risk for diabetes are being referred to, or participating in, prevention programs, indicating a need to improve outreach for lifestyle interventions, according to a new study published in the American Journal of Preventive Medicine.
Despite more than 25% of study participants indicating an interest in engaging in a prevention program, very few actually reported being referred or participating in a program.
With the rising burden of type 2 diabetes in the United States, prevention efforts aimed at evidence-based lifestyle interventions can help curb the disease in adults with prediabetes. The CDC estimates that 1 in 4 US adults have prediabetes, but only 11.6% are aware of their conditions.
In the community setting, pharmacists may frequently interact with patients who are at high risk of developing diabetes but are not aware of their condition, representing opportunities to promote interventions and potentially prevent or delay onset. The CDC previously released an action guide for community pharmacists designed to help them reach at-risk patients who could benefit from the National Diabetes Prevention Program lifestyle change program, which is led by the CDC.
For the study, researchers from Johns Hopkins University School of Medicine used data from the 2016 National Health Interview Survey from 28,345 adults living across the United States, which included self-reported participant information on diabetes diagnoses, screening, risk factors, referrals, and participation and interest in diabetes prevention programming.
Of these individuals, 2431 survey participants were eligible for the program due to their high risk of developing diabetes. Diabetes risk was based on body mass index and/or history of self-reported diagnosis of prediabetes or gestational diabetes during pregnancy.
Among the 2431 individuals, 4.2% reported ever being referred to a 12-month prevention program and only 2.4% reported participating, according to the study. The study showed that older adults and those with lower family incomes were 2 to 3 times more likely than younger and higher income individuals to participate. Additionally, African American and Asian adults were more likely than white adults to report referral to a program, the researchers noted.
“In our analyses, racial minorities were more likely to be referred, and low-income adults were more likely to participate,” lead study author Maya Venkataramani, MD, MPH, assistant professor of medicine at the Johns Hopkins University School of Medicine, said in a press release. “These are the groups that historically have poorer access to preventive services. They have a higher burden of diabetes-related complications. It is thus important confirm these trends, and if they hold, understand the reasons behind enhanced referral, participation, and retention.”
The researchers concluded that the findings highlight the need for enhanced efforts to improve program referral and access among individuals with prediabetes, as well as improving awareness of risk among this population.
Venkataramani M, Pollack CE, Yeh HC, et al. Prevalence and correlates of diabetes prevention program referral and participation. American Journal of Preventive Medicine. 2019. https://doi.org/10.1016/j.amepre.2018.10.005
Few At-risk Adults Getting the Diabetes Prevention Help They Need [news release]. Johns Hopkins University School of Medicine. https://www.hopkinsmedicine.org/news/newsroom/news-releases/few-at-risk-adults-getting-the-diabetes-prevention-help-they-need. Accessed April 25, 2019.