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New Medicare Benefit Aims to Prevent Diabetes

Program teaches participants healthy lifestyle habits

woman testing her blood sugar

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Major risk factors for diabetes include obesity, a sedentary lifestyle, and often a family history of the disease.

If you’re at risk of becoming one of the more than 25 percent of Americans age 65-plus with diabetes, you may be eligible for the new Medicare Diabetes Prevention Program (MDPP) designed to help prevent prediabetic individuals from developing the disease.

During the yearlong program, Medicare pays for prediabetic older adults to meet regularly in groups to learn and encourage one another to maintain healthy diets, good nutrition, and physical activity. For the first six months, participants attend 16 weekly sessions, after which they meet monthly. If participants meet the program’s weight-loss goal of at least five percent of their weight, they are invited to attend an additional year of health-maintenance sessions.

Held in local, informal settings, such as hospitals, community centers, YMCAs, and even grocery stores, sessions are facilitated by lifestyle coaches certified by the Centers for Disease Control and Prevention (CDC), who teach participants how they can change their lifestyle habits to lower their risk of developing diabetes.

Major risk factors for diabetes include obesity, a sedentary lifestyle, and often a family history of the disease. A blood glucose test can determine if you are prediabetic. You are eligible for MDPP if you are enrolled in Medicare Part B, are clinically overweight, and have elevated glucose levels that are not yet high enough to indicate diabetes. Your doctor can help you find a MDPP program near you.

The program is based on a groundbreaking National Institutes of Health study that indicates prediabetic adults over age 60 who make modest behavioral changes and lose five percent to seven percent of their body weight can reduce their risk of developing type 2 diabetes by 71 percent. People with higher-than-normal glucose tolerance levels are considered prediabetic if those levels are not yet high enough to indicate diabetes. Nearly half of all Americans age 65 and older are prediabetic, meaning they are likely to develop diabetes within a decade. And according to the CDC, 90 percent of Americans who are prediabetic don’t know it.

Kim Beazley, a lifestyle coach and registered dietician with Chester County Hospital in Pennsylvania, calls prediabetes “a warning light. People can change. They just need to overcome the negative self-talk that keeps them from meeting their goals.” This is what MDPP is designed to do.

Beazley, who recently graduated 12 people over age 64 from a MDPP trial program, says her group lost a combined total of 281 pounds. Individual participants achieved an average 10 percent loss in body weight, and several saw their blood glucose levels drop significantly. One participant lost 50 pounds. Another lost 65.

Beazley says the program’s group dynamic contributed significantly to its success. “Everyone is in the same boat and supports one another,” she says. “Just knowing they are not alone is helpful. They develop relationships over the year, and they encourage one another.”

Experts agree that the program’s focus on mutual accomplishment is a big factor in its success. William T. Cefalu, chief scientific, medical and mission officer at the American Diabetes Association, says in a statement that making the program physically — or even virtually — accessible to all Americans who can benefit from it is crucial.

“As participation in MDPP grows and individuals achieve success, we hope CMS [Centers for Medicare & Medicaid Services] continues its commitment to diabetes prevention by working to expand access to this program, including coverage for programs that offer virtual delivery of the MDPP,” says Cefalu.

Given the prevalence of diabetes among older adults, Cefalu says that caregivers should learn about the program and spread the word: “Community organizations and advocates can help by educating health care providers and the public about the program’s availability.”

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