Clinical practices play a crucial role in identifying patients at risk of diabetes. With 86 million adults with prediabetes in the U.S., there is an urgency to increase patient engagement. November is National Diabetes Awareness Month and a great time to start. Following is a five-step action plan with the resources physicians need to find local evidence-based diabetes prevention programs (DPPs), screen patients for prediabetes, persuade diagnosed patients to enroll in a program and bill for their time.

According to the Centers for Disease Control and Prevention (CDC), 90 percent of people with prediabetes don't know they have it. Prediabetes is a reversible condition, and the CDC has developed an evidence-based lifestyle change program that has been proved effective in reducing the risk of developing type 2 diabetes. Patients work with trained lifestyle coaches in small groups to make lasting lifestyle changes that include physical activity, healthy eating and stress reduction. The year-long program is available in person and online and cuts the risk of type 2 diabetes by more than half.

Follow these simple steps to screen patients and refer those with prediabetes to local evidence-based DPPs:

Several of the AMA’s diabetes awareness resources for patients are also available in Spanish.

Half of all Americans 65 or older have prediabetes. With its final rule on the Medicare Physician Fee Schedule, the Centers for Medicare and Medicaid Services (CMS) has expanded coverage of the National DPP to Medicare patients who are at risk of developing type 2 diabetes.

Meanwhile, state-level efforts have been improving screening of at-risk patients by health professionals and expanding coverage of DPPs by employers and insurers.

In Michigan, the AMA is engaged with Henry Ford Health System—one of the country’s preeminent health care organizations—to increase the number of physicians and other health professionals who are screening patients for prediabetes and to encourage referrals of high-risk patients to evidence-based DPPs.

The AMA has also partnered with the Michigan State Medical Society on a new effort aimed at reducing the incidence of type 2 diabetes. The two organizations joined the Michigan Department of Health and Human Services as it kicked off its statewide Diabetes Prevention Action Plan, which aims to increase awareness of prediabetes, expand health plan coverage of CDC-recognized DPPs and increase the number of health professionals in the state who screen and refer at-risk patients.

Michigan officials recently joined public health representatives from California, New York and South Carolina at the AMA’s Chicago headquarters to share key data and lessons learned in their efforts to expand access to, and increase use of, DPPs in their states.

And in Utah, Intermountain Healthcare is partnering with the AMA and Omada Health to create a road map for large health care organizations across the country to adopt proven online behavior change interventions for at-risk patients and to integrate those programs into physician referral and clinical workflow.

The AMA’s updated Prevent Diabetes STAT website now features more robust information on diabetes prevention, including the variety of screening methods, research on the effectiveness of evidence-based DPPs, details of coverage and cost of a CDC-recognized DPP and how to follow up with referred patients.

A module from the AMA’s STEPS Forward™ collection of practice improvement strategies includes more complete instructions for incorporating prediabetes screening into your practice. The module may also be completed for continuing medical education (CME) credit.

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