Prediabetes Day at AADE 2016 Conference Offers Optimistic Outlook on Diabetes Prevention

By Ava Runge

Advice for increasing daily activity, the new Fit2Me mobile app, and enthusiasm for the National Diabetes Prevention Program  

The 2016 American Association for Diabetes Educators annual conference was held last month in San Diego, CA, drawing thousands of attendees for four days of sessions on the latest in diabetes treatment, prevention, and education. An entire day was dedicated to prediabetes and the prevention of type 2 diabetes, with speakers touching upon nationwide implementation of the proven Diabetes Prevention Program (DPP) and the potential for lifestyle interventions to contribute to better blood sugar management.

diaTribe’s Top 3 Highlights:

1. Multiple speakers advocated strongly for widespread access to the Diabetes Prevention Program (DPP), a lifestyle education program that can help delay or prevent type 2 diabetes.

An AADE session featuring speakers from different states across the country focused on various strategies for implementing the DPP to meet their community’s unique needs. For example, Marci Butcher highlighted the value of using telemedicine to bring diabetes prevention education to remote areas of Montana, and Ann Constance discussed her team’s success using Stanford’s Diabetes Self-Management Program as an adjunct to typical diabetes self-management education in northern Michigan.

In addition, AADE’s Mrs. Joanna C. DiBenedetto expressed optimism for the DPP’s future, highlighting its positive study results (58% reduction in new onset of type 2 diabetes versus 31% with metformin) and important training and reimbursement considerations going forward. In terms of challenges for the DPP, she cited unawareness of prediabetes as a primary obstacle, explaining that only about 10 percent of those estimated to have prediabetes are aware of their high risk to develop type 2 diabetes. Another barrier AADE has found through its cooperative agreement with CDC is that although Certified Diabetes Educators and healthcare providers are experts at the delivery and oversight of the National DPP, they don't seem to have the time or resources to sell the program to payers to ensure reimbursement. In turn, this limits the reach by complicating participant recruitment and the sale of DPP coverage to insurance companies and employer groups.

The DPP is an excellent option for many people with prediabetes, and CMS has announced its support of Medicare coverage of the National DPP. To learn more about AADE DPP and the National DPP, including how to join a local program, visit the CDC website here. There are also digital versions of the DPP offered by Omada Health, Noom, and Canary Health.

For more on prediabetes, see diaTribe’s resource page here.

2. University of New Mexico’s Dr. Len Kravitz delivered an entertaining and interactive presentation offering simple tricks for staying active throughout the day. Type 2 diabetes develops gradually over time in response to a complex combination of genetic and environmental factors, many of which are difficult – if not impossible – to change. Dr. Kravitz highlighted the importance of frequent, low-intensity activity throughout the day to break up periods of sitting:

• While watching TV, get up and move during every commercial break (jumping jacks, marching in place, taking a lap around the room/house).

• Drink water often during the workday to take more frequent bathroom or refill breaks.

• Get to work 10 minutes early and walk around the block, or go on walking meetings.

• [Here at diaTribe, we’ve found activity tracking devices and smartwatches are very helpful for understanding how much activity and sitting you are doing each day, and for motivating much more activity. Read more here.]

The idea is that small-scale modifications will be easy to adopt, and when summed, they can meaningfully disrupt daily periods of inactivity. For hundreds more intervention ideas for work, school, and home, visit “Don’t Sit, Get Fit”, a website created by Dr. Kravitz and his students at the University of New Mexico.

3. AstraZeneca displayed Fit2Me in the AADE Conference Exhibit Hall, a free diet and lifestyle program with mobile apps for Apple (download here) and Android devices (download here) that allows people with diabetes to create customized health and fitness plans. [AstraZeneca also recently extended its Fit2Me app to include helpful resources for patients with, or at risk for, heart disease]. The program consists of four basic components:

• “Food plan” prompts users to pick their favorite ingredients, cuisines, and recipes, providing tailored meal advice in response. The app can also help users plan and prepare meals, shop for ingredients, and make healthier choices when dining out.
• “My Activity” offers tailored fitness plans based on users’ preferred levels and types of activities, as well as where and when they typically exercise. The app also includes step-by-step instructional videos to demonstrate exercises. 
• Users can fill out the “My Treatment Support” profile to receive information on proven type 2 diabetes medications and reminders for when to take medications, refill prescriptions, and schedule diabetes care appointments. It also logs blood sugars so users can monitor trends over time.
• The “My Plan Team” consists of a digital coach, as well as access to type 2 diabetes-trained nurses and counselors. The team offers motivational support and rewards to encourage continued engagement in the program.