Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

Preventing T2D Through Lifestyle Change Programs

Diabetes Care; ePub 2017 Jul 21; Ely, et al

Widespread implementation of a lifestyle change program to prevent type 2 diabetes (T2D) has shown promising results during its first 4 years, with greater duration and intensity of session attendance resulting in a higher percent of body weight loss overall, a recent study found. The study performed an analysis from data on 14,747 adults enrolled in year-long T2D prevention programs from Centers for Disease Control and Prevention’s (CDC) National Diabetes Prevention Program (National DPP) from February 2012 through January 2016. Researchers found:

  • Participants attended an average of 14 sessions over an average of 172 days in the program.
  • 35.5% of participants achieved the 5% weight loss goal.
  • Participants reported a weekly average of 152 minutes of physical activity, with 41.8% meeting the physical activity goal of 150 minutes per week.
  • Participants lost 0.3% of body weight for every additional session attended and every 30 minutes of activity reported.


Ely EK, Gruss SM, Luman ET, et al. A national effort to prevent type 2 diabetes: Participant-level evaluation of CDC’s National Diabetes Prevention Program. [Published online ahead of print July 21, 2017]. Diabetes Care. doi:10.2337/dc16-2099.


86 million Americans have prediabetes and are at heightened risk of developing diabetes. In a trial that looked at over 3,000 individuals with prediabetes, the National Diabetes Prevention Program showed that a multi-component lifestyle intervention program with a large number of sessions over a year, combined with a targeted weight loss goal of 5% to 7% and an exercise goal of 150 minutes of moderate intensity exercise per week, decreased the number of people going on to develop diabetes compared to usual care by about two-thirds.1 Based on these results and the increasing epidemic of diabetes, the CDC developed and implemented the National DPP to disseminate this program broadly across the population. The program consists of a minimum of 22 sessions over the year, with 16 hourly sessions at weekly intervals during the first 6 months, and then 6 monthly sessions during the subsequent 6 months. This study, which reports on the first 4 years of the widespread implementation of this program, shows that the program works not only in a research setting like that of the DPP, but also in the real-world setting in which the CDC has rolled out the program. These programs are excellent, worthwhile resources to which we can refer motivated patients with prediabetes. —Neil Skolnik, MD

  1. Knowler WC, Barrett-Connor E, Fowler SE, et al; Diabetes Prevention Program Research Group. Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N Engl J Med. 2002;346:393–403.