For patients with prediabetes, find lifestyle support that fits

Sara Berg, MS , News Editor

The stakes are clear. Prediabetes affects 84 million U.S. adults, and 90 percent do not know they have it. To prevent type 2 diabetes, the AMA and Centers for Disease Control and Prevention recommend physicians screen, test and act today by referring patients to diabetes prevention programs.

But doing that in a brief counseling session may not be enough. Learn what physicians can and should to help patients with prediabetes find the lifestyle change program that will be most effective in their effort to prevent 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 Diabetes Prevention Program lifestyle-change program based on their individual needs.

To help stop the progression from prediabetes to type 2 diabetes, it is important to understand what really matters to patients.

“The biggest thing for doctors to realize is the brief counseling that we tend do in our office, like advising people to eat better, lose weight and exercise more, doesn’t make a very big difference,” said Kate Kirley, MD, a family physician and director of chronic disease prevention at the AMA.

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Brief counseling is “still good for us to do, but that is only the first step,” said Dr. Kirley. “You have to take the next step, which is to connect your patient to an intensive lifestyle change program.”

And, moreover, that program should fit the patient’s individual needs and goals.

“There are a lot of things that are needed to help patients work through some of the key logistics of engaging with a program that requires a long-term commitment,” said Dr. Kirley.

For example, physicians should find different types of programs for patients. If a patient works third shift, he or she is unlikely to be able to attend a program that meets in the evenings. A digital program might work for them instead. Working with patients on the logistical issues is important. 

“Form groups that people can get comfortable in,” Dr. Kirley said. “Not that diversity doesn’t have a place here, but the fact is that for a group class a lot of people might be more comfortable being with people that they see as similar to themselves.”

“Having a culturally competent program is really important,” she added. “Those types of things are important as well for keeping people engaged.”

Another logistical issue is recognizing that not every patient wants to join a group. For some people, attending a group is often too intimidating. An online or individual program that offers one-on-one interaction might be a better match.

There are different ways to approach diabetes prevention with respect to each patient’s needs and learning styles.

“Trying to match the type of program to the person is really important for getting them started in the first place and then having them actually stay in the program long term,” said Dr. Kirley.

The AMA’s Diabetes Prevention Guide provides valuable resources for patient educational materials that can serve as the backbone for having a conversation with your patient about what their risk is and what the program involves. It also provides key motivating messages to share with patients.