Evaluation of a community Diabetes Prevention Program delivered by diabetes educators in the United States: One-year follow up

2014 ◽  
Vol 106 (3) ◽  
pp. e49-e52 ◽  
Author(s):  
M. Kaye Kramer ◽  
Rachel G. Miller ◽  
Linda M. Siminerio
Keyword(s):  
United States ◽  
Prevention Program ◽  
Diabetes Prevention ◽  
Diabetes Prevention Program ◽  
The United States ◽  
One Year ◽  
Diabetes Educators

scholarly journals Patient-Centered Goal-Setting in the National Diabetes Prevention Program: A Pilot Study

2021 ◽  
Author(s):  
Natalie D. Ritchie ◽  
Katherine A. Sauder ◽  
Peter G. Kaufmann ◽  
Leigh Perreault
Keyword(s):  
Physical Activity ◽  
Weight Loss ◽  
Prevention Program ◽  
Diabetes Prevention ◽  
Diabetes Prevention Program ◽  
Patient Centered ◽  
Weekly Physical Activity ◽  
One Year ◽  
Design And Methods

<b>Introduction: </b>Difficulty achieving preset goals (e.g., ≥5% weight loss, ≥150 minutes of weekly physical activity) in the yearlong National Diabetes Prevention Program (NDPP) can prompt dropout and diminish benefits. We piloted a more patient-centered NDPP adaptation (NDPP-Flex) that promotes a variety of attainable and individually-tailored goals to reduce diabetes risks, along with flexibility to adjust goals each week as needed. <p><b>Research Design and Methods: </b>Retention, physical activity, weight, and HbA1c were evaluated among diverse participants with diabetes risks who received our pilot of NDPP-Flex beginning in January and July 2018 (<i>n</i>=95), with a planned comparison to standard NDPP delivery in preceding cohorts that launched between September 2016 and October 2017 (<i>n</i>=245). Both the standard NDPP and NDPP-Flex interventions were one year in duration and implemented in phases (i.e., non-randomized). </p> <p><b>Results: </b>Average adjusted retention (e.g., 158.90 ± 15.20 vs. 166.71 ± 9.38 days; <i>P</i>=.674), physical activity (157.97 ± 11.91 vs. 175.64 ± 7.54 weekly minutes; <i>P</i>=.231), and weight loss (1.46 ± 0.38% vs. 1.90 ± 0.24%; <i>P</i>=.396) were similar between NDPP-Flex versus standard NDPP. However, NDPP-Flex participants had greater HbA1c reduction on average (0.22 ± 0.05% vs. 0.06 ± 0.03%, <i>P</i>=.018) and were more likely to have normoglycemia at follow-up (OR 4.62; <i>P</i>=.013; 95% CI 1.38-15.50) than participants in the standard NDPP. </p> <p><b>Conclusions: </b>An adapted, more patient-centered NDPP that focuses on flexible, self-selected goals may be a promising strategy to improve glycemia even in the absence of substantial weight loss.<b></b></p>

scholarly journals An ounce of prevention is worth a pound of cure: considerations for pharmacists delivering the National Diabetes Prevention Program

2021 ◽  
Vol 19 (2) ◽  
pp. 2426
Author(s):  
Dave L. Dixon ◽  
Evan M. Sisson ◽  
Lauren G. Pamulapati ◽  
Rowan Spence ◽  
Teresa M. Salgado
Keyword(s):  
United States ◽  
Prevention Program ◽  
Diabetes Prevention ◽  
Scale Up ◽  
Diabetes Prevention Program ◽  
The United States ◽  
Community Pharmacies ◽  
Local Health ◽  
Factors Affecting ◽  
Personnel Recruitment

Prediabetes is highly prevalent in the United States affecting over 88 million adults. In 2010, the Centers for Disease Control and Prevention (CDC) established the National Diabetes Prevention Program (NDPP), an intensive lifestyle program consisting of a 16-lesson curriculum focused on diet, exercise, and behavior modification, with the ultimate goal to reduce progression from prediabetes to diabetes. Despite tens of millions of adults potentially qualifying to participate in the program, the uptake of the NDPP has been exceedingly low. As a result, the CDC has focused its efforts on engaging with local health departments and community partners, including community pharmacies, across the United States to scale-up enrollment in the NDPP. In this commentary we discuss factors affecting implementation of the NDPP in community pharmacies and other settings where pharmacists practice, including training, space, personnel, recruitment and enrollment, retention, and sustainability.

scholarly journals Patient-Centered Goal-Setting in the National Diabetes Prevention Program: A Pilot Study

2021 ◽  
Author(s):  
Natalie D. Ritchie ◽  
Katherine A. Sauder ◽  
Peter G. Kaufmann ◽  
Leigh Perreault
Keyword(s):  
Physical Activity ◽  
Weight Loss ◽  
Prevention Program ◽  
Diabetes Prevention ◽  
Diabetes Prevention Program ◽  
Patient Centered ◽  
Weekly Physical Activity ◽  
One Year ◽  
Design And Methods

<b>Introduction: </b>Difficulty achieving preset goals (e.g., ≥5% weight loss, ≥150 minutes of weekly physical activity) in the yearlong National Diabetes Prevention Program (NDPP) can prompt dropout and diminish benefits. We piloted a more patient-centered NDPP adaptation (NDPP-Flex) that promotes a variety of attainable and individually-tailored goals to reduce diabetes risks, along with flexibility to adjust goals each week as needed. <p><b>Research Design and Methods: </b>Retention, physical activity, weight, and HbA1c were evaluated among diverse participants with diabetes risks who received our pilot of NDPP-Flex beginning in January and July 2018 (<i>n</i>=95), with a planned comparison to standard NDPP delivery in preceding cohorts that launched between September 2016 and October 2017 (<i>n</i>=245). Both the standard NDPP and NDPP-Flex interventions were one year in duration and implemented in phases (i.e., non-randomized). </p> <p><b>Results: </b>Average adjusted retention (e.g., 158.90 ± 15.20 vs. 166.71 ± 9.38 days; <i>P</i>=.674), physical activity (157.97 ± 11.91 vs. 175.64 ± 7.54 weekly minutes; <i>P</i>=.231), and weight loss (1.46 ± 0.38% vs. 1.90 ± 0.24%; <i>P</i>=.396) were similar between NDPP-Flex versus standard NDPP. However, NDPP-Flex participants had greater HbA1c reduction on average (0.22 ± 0.05% vs. 0.06 ± 0.03%, <i>P</i>=.018) and were more likely to have normoglycemia at follow-up (OR 4.62; <i>P</i>=.013; 95% CI 1.38-15.50) than participants in the standard NDPP. </p> <p><b>Conclusions: </b>An adapted, more patient-centered NDPP that focuses on flexible, self-selected goals may be a promising strategy to improve glycemia even in the absence of substantial weight loss.<b></b></p>

scholarly journals Increased Early Revision Rate with the INFINITY Total Ankle Prosthesis

2018 ◽  
Vol 3 (3) ◽  
pp. 2473011418S0003
Author(s):  
Elizabeth Cody ◽  
Michel Taylor ◽  
James Nunley ◽  
Selene Parekh ◽  
James DeOrio
Keyword(s):  
United States ◽  
Tibial Component ◽  
Revision Rate ◽  
The United States ◽  
Additional Patient ◽  
Foot And Ankle ◽  
Early Revision ◽  
One Year ◽  
Component Loosening

Category: Ankle Arthritis Introduction/Purpose: Modern total ankle arthroplasties (TAAs) have demonstrated improved survival rates at early- and mid-term follow-up, with revision rates ranging from 4 to 8% at five years. The INFINITY total ankle system (Wright Medical Technology, Arlington, TN) was first used in the United States in 2014. Its advantages include the ability to use patient-specific instrumentation and the option to choose between talar dome resurfacing and flat-cut talar components. While this implant is currently popular in the United States, clinical outcomes have not yet been reported. Our aim was to identify the rate of early revision among patients receiving the INFINITY prosthesis. Methods: Patients from two prospectively-collected databases at the authors’ institution were screened for inclusion in the present study. All patients who underwent a primary TAA with the INFINITY prosthesis and who were at least one year postoperative were included. All surgeries were performed by one of two orthopaedic foot and ankle surgeons with extensive experience in total ankle arthroplasty. The primary outcome was the need for revision surgery, which was defined as removal of one or both metal components. Peri-implant lucency at most recent follow-up was a secondary outcome. Anteroposterior and lateral radiographs at most recent follow-up were graded for lucency independently by two reviewers, both orthopaedic foot and ankle fellows, for individual peri-implant zones (Figure). Each zone was only considered “lucent” if recorded as such by both reviewers. Results: 160 patients underwent TAA with the INFINITY prosthesis between August 2014 and November 2016 with a mean 20 months of follow-up (range, 12-37). Six patients were lost to follow-up. Sixteen patients (10%) underwent revision a mean 1.2 years postoperatively. Revision was performed most commonly for tibial component loosening (seven patients, 4.4%) and deep infection (five patients, 3.1%). Of cases with tibial loosening, progressive lucency and/or subsidence was obvious radiographically in four patients; one patient had equivocal radiographs but loosening was suggested on single-photon emission computed tomography; and two patients revised for persistent pain had loosening confirmed intraoperatively. Of the 108 patients with retained components and at least one year of radiographic follow-up, eight (7.4%) had global lucency around the tibial component at most recent follow-up. Conclusion: Our initial review of patients undergoing TAA with the INFINITY prosthesis demonstrates an elevated early revision rate due to tibial component loosening. The reasons for this finding remain unclear, but could possibly include inadequate bony purchase of the implant’s three prongs, particularly in patients with large preoperative deformities or with imperfect component alignment. We plan to further investigate the possible reasons for this finding in the future by assessing additional patient factors, including age, sex, arthritis type, tobacco use, pre- and postoperative coronal and sagittal alignment, and presence of ipsilateral hindfoot fusion.

Abstract P121: Comparative Effectiveness Study of the Diabetes Prevention Program in Families: Preliminary Results

Circulation ◽  
2015 ◽  
Vol 131 (suppl_1) ◽  
Author(s):  
Jennifer Wessel ◽  
Erin O'Kelly-Phillips ◽  
Kelly Palmer ◽  
Chandan Saha ◽  
Tamara Hannon ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Prevention Program ◽  
Diabetes Prevention ◽  
Intervention Group ◽  
Diabetes Prevention Program ◽  
Comparative Effectiveness Study ◽  
Develop Type ◽  
History Of ◽  
Family Based

The prevalence of gestational diabetes (GDM) is increasing substantially and currently affects up to 14% of pregnancies. As many as 70% of women with GDM will develop type 2 diabetes (T2D) in the next 10 years. Moreover as many as 40% of children exposed to in-utero diabetes will develop obesity and T2D. The Diabetes Prevention Program (DPP) is an evidence-based lifestyle intervention that has been shown to lower T2D risk by 58% in high-risk adults. Family based lifestyle interventions that target either children, parents or both have reported mixed results. We modified the DPP curriculum to use with families (DPPF) and recruited mothers with a history of GDM and their children 8-15 years old. We randomized n=130 families to test which method of delivering the DPPF (mothers only (M) or mothers and their children (M+C)) is more effective at lowering families T2D risk. Baseline characteristics of women were similar among each intervention group (n=65 M and n=65 M+C, respectively): age (38±8 vs 39±11, P=0.5), ethnicity (Black 55% vs 55%, White 20% vs 17%, Latino 20% vs 27%, other 5% vs 2%, P=0.6), body mass index (BMI, 37±8 vs 38±7, P=0.24), systolic blood pressure (SBP, 121±11 vs 122±13, P=0.8), diastolic blood pressure (DBP, 103±26 vs 105±21, P=0.6), HbA1c (5.6±0.4 vs 5.7±0.3, p=0.2). The majority of women self-reported low levels of physical activity (PA): moderate PA (2 days or less per week, 42% vs 26%, P=0.06) or vigorous PA (2 days or less per week, 38% vs 25%, P=0.1), and high levels of sedentary activities (3 or more hours per day, 49% vs 58%, P=0.2). For diet related obesogenic behaviors women self-reported high levels of eating meals while watching TV (3 days or more per week, 58% vs 74%, P=.06) and eating at restaurants (3 days or more per week, 28% vs 41%, P=0.1). Follow-up is ongoing and currently n=32 families have completed the 3-month follow-up. Preliminary analyses of mothers show decreases in HbA1c (-.01±.3 vs -.1±.2), SBP (-9.7±30 vs -3.1±8), DBP (-8±19 vs -1±9) but not BMI (0.07±1.6 vs 0.04±1.2); however results were not significantly different by intervention group.

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