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Medicare moves to prevent diabetes in people at high risk

A small trial of the Diabetes Prevention Program showed weight loss among participants and lowered risk for the disease.
By Stephen Feller   |   March 23, 2016 at 2:48 PM

WASHINGTON, March 23 (UPI) -- The federal government announced plans to expand a Medicare program to help people at risk for diabetes avoid developing the disease after finding it was successful in a smaller trial.

The Diabetes Prevention Program helped Medicare beneficiaries lose weight and lower risk for the disease, while saving a few thousand dollars per enrollee for the federal health program by encouraging good health practices.

While 30 million people in the United States already have type 2 diabetes, another 86 million have prediabetes and are at high risk for developing it. High blood glucose levels, though not high enough to be diagnosed as diabetic, qualify someone as prediabetic and is likely to develop diabetes within the following decade.

Participants in the program attend weekly meetings with a lifestyle coach who trains them in long-term dietary change, physical activity and other behavioral changes to control weight and lower diabetes risk.

The program was authorized in Congress as part of the Affordable Care Act, with the Department of Health and Human Services giving the YMCA an $11.8 million grant to test the program in eight states.

"This program has been shown to reduce health care costs and help prevent diabetes, and is one that Medicare, employers and private insurers can use to help 86 million Americans live healthier," Sylvia Burwell, secretary of the Department of Health and Human Services, said in a press release. "The Affordable Care Act gave Medicare the tools to support this groundbreaking effort and to expand this program more broadly. Today's announcement is a milestone for prevention and America's health."

During the 15-month trial at the YMCA, HHS reports about 6,000 people participated in the program, with 25.4 percent completing more than 17 sessions, 37.5 percent completing between nine and 16 sessions, and 37 percent completing fewer than nine sessions.

The goal was to improve health by increasing nutrition and physical activity, with a goal for each participant to lose five percent of their body weight. The weight goal was met, as participants who attended at least four sessions lost 4.73 percent of their weight, and those who showed up at least nine times lost an average of 5.17 percent of body weight.

HHS researchers also report $2,650 was saved per enrollee in the program when compared to similar Medicare beneficiaries during the 15-month period -- at least enough money to fund the program.

The researchers say more, and larger, trials of the program are necessary -- such as the one just announced -- in order to see if the program continues to be financially viable, and the long-term effects on health for participants must be measured. In the short term, the program is promising, researchers said.

"Beneficiaries participating in diabetes prevention programs have achieved success with losing weight and reducing the incidence of diabetes," Paul Spitalnic, chief actuary at the Centers for Medicare and Medicaid Services, wrote in his certification of the Diabetes Prevention Program trial results. "While each of the programs we evaluated has some limitations, we believe that the results indicate that the intervention has resulted in reductions in medical spending in the near term."

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