DIABETES PREVENTION PROGRAM LiqhwaNcube,WhartonDeanScholarMentor:Dr JudithMcKenzie,MD,MPH

THE PROGRAM

• The Diabetes Prevention Program (DPP) is:

vA CDC lifestyle intervention program

vDesigned to help prevent progression of pre-diabetes to diabetes

vFocuses on education and behavior change

SourceCDC

PROGRAM GOALS Weight loss (5-7%)Healthy Eating Physical activity

v at least 150 mins a weekvE.g. 5 days 30 min per dayvEach time at least 10 minutes

Motivation

TYPICAL DPP PARTICIPANTS

TYPICAL DPP PARTICIPANTS

vSam is 45. He is short and weighs over 250 pounds thus his BMI is more than 30. Sam goes to work from 7-7 everyday and he is usually tired when he gets home . He buys dinner from restaurants on his way back from work. Quite often he has midnight snacks like potato crisps . Sam hardly gets 6 hours of sleep

TYPICAL DPP PARTICIPANTS

• Anne is a 50 year old mother of 4 . No history of diabetes in her family but she was diagnosed with gestational diabetes in her fourth pregnancy. Her BMI is 28 . Anne cooks for her family. However she doesn't follow the recommended daily allowance. Anne would love to know how to prepare cost effective healthy meals for her family

NIH STUDY RESULTS

• Reduction in progression from pre-diabetes to diabetes vMean age = 51 yovMetformin by 31%vIntensive, sustainable,

lifestyle intervention by 58% Ø 71% for those over 60 years

WHY THE DPP?

Obesity is prevalent

PREDIABETES

vObesity is major risk factor for diabetes

v30% of US population are pre- diabetic

v90% are unaware of their status

vPre-diabetics at risk for diabetes (30-50% lifetime conversion rate)

v15-30% progress to diabetes within 5 years

COST OF CARE FOR DIABETES

IN THE WORKPLACE

• Compared with non-obese workers, obese workers miss more workdays due to illness, injury, or disabilityv Illness – associated metabolic consequences e.g. diabetes

v Injury – sustain more injuries

v Disability- musculoskeletal etc.

• Obesity associated with higher employer costs fromv Direct health care and insurance claims

v Indirect costs from lost productivity

WHY THE HUP PILOT STUDY?

vOcc med priorities vThe incidence of chronic diseasesvOnsite clinics

THE STRUCTURE OF THE NDPP• Yearlong Program

• Curriculumv16 coaching sessions minimum

vOver 26 monthsvFirst 3 months once/weekvSecond 3 months once/2 weeks

vFollowed by 6 sessions minimumvOver subsequent 26 weeks (6 months)v1-2 times/month

THE DPP AT HUP

v 3monthpilotstudyv6Monthsv2lifestylecoachesvMakeupsessions

A GLANCE INTO THE CURRICULUM • Skill Building

v Be a fat and calorie detectivev Move those muscles

• Responding to the external environmentv Take charge of what is around youv Four keys to healthy eating out

• Psychological and emotional aspects of lifestyle changev Talk back negative thoughtsv Make social cues work for you

ACTION PLAN

UPENN DPP PILOT RESULTS

PREDIABETES SCREENING TEST

PREDIABETES SCREENING RESULTS

Average score = 13range (10-17)

WEIGHT

Average weight loss - 1.6% Range (0.5 -2.34)

PHYSICAL ACTIVITY

Allparticpants activity>50

All participants > 150mins

HBA1C

vInitial average – 6.1vAverage@ 6 months –

5.8

HbA1c levels

SIMILAR INITIATIVES

• The Urban Nutrition Initiative (Netter Centre)

MY ROLE

vTaught a session vData entry vReviewed and helped analyze data

LESSONS LEARNT

• Participants to make a commitment to year long program

• Room needs to encourage more engaged sitting • Taking charge of my health is in my control • Healthy eating and lifestyle• Engaging with a team

ACKNOWLEDGEMENTS

• Joanne Levy• Safa Browne• SUMR scholars • Dr McKenzie , Dr Krystal Franklin, Jamie and Kourteney

QUESTIONS