It is common to hear about type 2 diabetes, but its common precursor, prediabetes, doesn’t get as much attention. To master the conversation with patients on prediabetes and prevention, it is important for physicians and their clinical care teams to effectively explain what prediabetes is, what it means, and what resources are available to help prevent the onset of type 2 diabetes.
The AMA’s Diabetes Prevention Guide supports physicians and health care organizations in defining and implementing evidence-based diabetes prevention strategies. This comprehensive and customized approach helps clinical practices and health care organizations identify patients with prediabetes and manage the risk of developing type 2 diabetes, including referring patients at risk to a National DPP lifestyle-change program based on their individual needs.
When determining how to talk with patients about prediabetes, here are some frequently asked questions to review with your care team.
With 90% of patients unaware that they have prediabetes, it is important for your team to become familiar with basic questions about the condition. When discussing prediabetes with patients, share what it is, what causes it and how it is diagnosed. This will help patients better understand prediabetes and prevention measures.
Patients may also wonder about the signs and symptoms of prediabetes and if it is a dangerous condition. Most people do not know they have prediabetes because there are usually no signs or symptoms. And while prediabetes is not a life-threatening condition, patients should understand that it increases their risk for developing type 2 diabetes, high blood pressure, stroke and heart attack.
Weight loss is a goal of the National DPP lifestyle change program. However, it does not focus on specific diet or exercise programs. Designed by the Centers for Disease Control and Prevention, the program aims to help people make more informed choices and lasting changes in their lives.
It is important for patients to understand that this program will help them learn to try new things, share their experiences with others and build new habits. Patients will also learn how to improve their overall health, which will reduce their risk of developing type 2 diabetes.
The National DPP lifestyle-change program runs for 12 months. The first six months will include weekly meetings, while the second half will be once or twice a month. If patients feel like they’ve learned enough in the first six months, they might think they can skip the second half. This is not the case.
Making lifestyle changes is an ongoing process and patients should remain in the program for the full year. This will help them to stick to new habits and avoid slipping back into old ones. For patients who are having trouble reaching their goals in the first six months, the program’s lifestyle coach can offer further support, along with fellow participants.
The program will help participants learn new skills, including cooking healthier meals and being more physically active, but the lifestyle coach is there to do more than that. These classes help patients set and meet goals, and learn how to stay motivated. Patients will also be joined by other people who have similar goals for lifestyle change.
In the first half of the program, participants will learn to:
- Eat healthy without giving up all their favorite foods.
- Add physical activity even when they don’t think they will have time.
- Manage stress.
- Cope with challenges that can derail hard work.
- Get back on track if they stray from their plan.
The second half of the program is about enhancing skills and maintaining the changes that have been made.
While these questions are a great place to start, the AMA recommends determining how to handle blind outreach with patients who may not know they have prediabetes, have answers specific to your organization’s National DPP lifestyle-change program, and have a method to connect patients back to their physician or care team if they have questions.