Diet, exercise programs increasingly effective at reducing type 2 diabetes risk

Combined diet and physical activity promotion programs are an effective prescription for diabetes prevention – they have a preferred [U.S. Diabetes Prevention Program (DPP)] formulation, a minimum dose, and must be taken continuously. This treatment has become increasingly available, but most people remain unaware of their need for a prescription or where to fill it. Health care providers should assume a greater role in performing recommended screening and linking high-risk patients with combined diet and physical activity promotion programs; the National DPP registry and the YMCA of the USA’s program database should be used as tools. Health payers should recognize that these programs meet Affordable Care Act–directed coverage requirements for recent [U.S. Preventive Services Task Force (USPSTF)] recommendations. As a society, we should no longer hold the potential to reduce the burden of diabetes for ransom by continuing to await further evidence that interventions will be cost-saving or prevent myocardial infarctions or deaths. It is imperative that we promote a known cost-effective intervention that improves health, reduces the need for medication, and has the potential to enable millions of Americans to evade a remaining lifetime burdened by the daily management of diabetes.

Dr. Ronald T. Ackerman is professor of medicine and director of the Center for Community Health at Northwestern University’s Feinberg School of Medicine in Chicago. He did not report any disclosures. (Ann Intern Med. doi:10.7326/M15-1563).