The national YMCA of the USA was awarded a three-year, $12 million grant from the federal Center for Medicare and Medicaid Innovation to make its diabetes-prevention program available to about 10,000 Medicare patients in 17 communities. Medicare fee-for-service patients pay no additional out-of-pocket cost for the YMCA class and 27 private health plans cover it. For other patients, the fee is charged on an income-based sliding scale that varies by facility and can reach $400, says Matt Longjohn, MD, MPH, the national health officer at YMCA of the USA.
26 million Americans have diabetes, more than 8% of the U.S. population. Researchers estimate that one in three U.S. patients — about 80 million — can be classified as prediabetic either because of their scores on diagnostic blood tests or a combination of age, family history of diabetes and other factors. Patients with prediabetes are two to five times likelier than patients with normal blood glucose to develop type 2 diabetes. Ten percent of prediabetics will become diabetics within seven years, says Ronald T. Ackermann, MD, MPH, associate professor of medicine at Northwestern University Feinberg School of Medicine in Chicago.
A randomized controlled trial of more than 3,000 patients with prediabetes found that patients exposed to an intensive lifestyle-modification program that aimed for 7% weight loss and 150 minutes in weekly physical activity were 58% less likely to develop diabetes than those who received standard lifestyle recommendations and took a placebo pill. During the study’s three-year period, the patients who got the comprehensive lifestyle support in the form of 16 lessons covering diet, exercise and behavior modification avoided diabetes at a rate nearly double that of patients who got the standard advice and took the diabetes drug metformin.
For every seven prediabetics who participated in the lifestyle-modification program, one case of diabetes was avoided, said the study in the Feb. 7, 2002 issue of The New England Journal of Medicine.