Use and Impact of Type 2 Diabetes Prevention Interventions

被引:11
作者
Campione, Joanne R. [1 ]
Ritchie, Natalie D. [2 ]
Fishbein, Howard A. [3 ]
Mardon, Russell E. [3 ]
Johnson, Maurice C., Jr. [3 ]
Pace, Wilson [4 ]
Birch, Rebecca Jeffries [3 ]
Seeholzer, Eileen L. [5 ]
Zhang, Xuanping [6 ]
Proia, Krista [6 ]
Siegel, Karen R. [6 ]
Bullard, Kai McKeever [6 ]
机构
[1] Westat Corp, 2530 Meridian Pkwy,Suite 200, Durham, NC 27703 USA
[2] Denver Hlth & Hosp Author, Off Res, Denver, CO USA
[3] Westat Corp, Rockville, MD USA
[4] DARTNet Inst, Aurora, CO USA
[5] MetroHlth, Cleveland, OH USA
[6] Ctr Dis Control & Prevent, Atlanta, GA USA
关键词
LIFE-STYLE INTERVENTION; WEIGHT-LOSS; FOLLOW-UP; REDUCTION; PROGRAM; METFORMIN;
D O I
10.1016/j.amepre.2022.04.002
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
Introduction: RCTs have found that type 2 diabetes can be prevented among high-risk individuals by metformin medication and evidence-based lifestyle change programs. The purpose of this study is to estimate the use of interventions to prevent type 2 diabetes in real-world clinical practice set-tings and determine the impact on diabetes-related clinical outcomes. Methods: The analysis performed in 2020 used 2010-2018 electronic health record data from 69,434 patients aged >= 18 years at high risk for type 2 diabetes in 2 health systems. The use and impact of prescribed metformin, lifestyle change program, bariatric surgery, and combinations of the 3 were examined. A subanalysis was performed to examine uptake and retention among patients referred to the National Diabetes Prevention Program. Results: Mean HbA1c values declined from before to after intervention for patients who were pre-scribed metformin (-0.067%; p < 0.001) or had bariatric surgery (-0.318%; p < 0.001). Among patients referred to the National Diabetes Prevention Program lifestyle change program, the type 2 diabetes postintervention incidence proportion was 14.0% for nonattendees, 12.8% for some attendance, and 7.5% for those who attended >= 4 sessions (p < 0.001). Among referred patients to the National Diabetes Prevention Program lifestyle change program, uptake was low (13% for 1-3 sessions, 15% for >= 4 sessions), especially among males and Hispanic patients. Conclusions: Findings suggest that metformin and bariatric surgery may improve HbA1c levels and that participation in the National Diabetes Prevention Program may reduce type 2 diabetes incidence. Efforts to increase the use of these interventions may have positive impacts on diabetes -related health outcomes. (C) 2022 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.
引用
收藏
页码:603 / 610
页数:8
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