Diabetes Prevention Program Research Study Overview
The Diabetes Prevention Program (DPP) was a major research study aimed at discovering whether food and exercise, or the oral diabetes drug, metformin, could prevent or delay the onset of type 2 diabetes in people with impaired glucose tolerance (IGT).
DPP Study Design and Goals
The DPP was led by the National Institutes of Health and supported by CDC. Participants from 27 clinical centers around the country were randomly assigned into 3 treatment groups. The first group, the lifestyle intervention group, received an intensive one-on-one intervention with a health care provider to address nutrition, exercise, and behavior modification. By eating less fat and fewer calories and exercising for a total of 150 minutes a week, group members aimed to lose 5 to 7 percent of their body weight and maintain that loss.
The second group received standard care and took 850 mg of metformin twice a day. The third group received standard care and took a placebo instead of metformin. The metformin and placebo groups also received information on diet and exercise, but no intensive intervention.
All 3,234 study participants were overweight and had IGT, well-recognized risk factors for developing type 2 diabetes. In addition, 45 percent of the participants were from minority groups that are at increased risk of developing diabetes, including African Americans, Hispanic Americans/Latinos, Asian Americans or Pacific Islanders, or American Indians.
The DPP research study found that, over the 3-year study, improved nutrition and exercise (lifestyle intervention) reduced the chances that a person with IGT would develop diabetes by 58 percent. The drug metformin also reduced risk, although less dramatically, by 31 percent. The DPP research study saw positive results more quickly than expected so, on the advice of an external monitoring board, the studywas halted a year earlier than originally planned. The researchers published their findings in the February 7, 2002, issue of The New England Journal of Medicine.
Resources Available in Spanish
- Get the CDC prediabetes screening quiz widget in Spanish for your Web site.
- Read information in Spanish from CDC about primary prevention of type 2 diabetes.
- Find CDC's Spanish language resources about diabetes.
- Read information in Spanish from the National Diabetes Education Program about the risk for developing type 2 diabetes and the small steps a person can take to delay or prevent the disease.
Frequently Asked Questions
Who should participate in the National Diabetes Prevention Program Lifestyle Intervention?
The National Diabetes Prevention Program lifestyle intervention is specifically designed for persons that have prediabetes or are at high risk for type 2 diabetes.
What is the goal of the National Diabetes Prevention Program?
Systematically scale the translated model of the Diabetes Prevention Program (DPP) for high risk persons in collaboration with organizations that have necessary infrastructure, health payers, health care professionals, public health, academia, and others to reduce the incidence of type 2 diabetes in the United States.
Why do we need a national diabetes prevention program?
The numbers tell the story—
- An estimated 79 million Americans have prediabetes, a condition that can lead to type 2 diabetes and heart attack and stroke if not addressed.
- The percentage of Americans with diabetes has more than tripled in the past two decades.
- CDC estimates that as many as 1 of 3 American adults could have diabetes in 2050 if current trends continue.
Clinical studies have demonstrated that participating in classes like those offered in the National Diabetes Prevention Program lifestyle intervention often prevents or delays the onset of type 2 diabetes among people with prediabetes.
Preventing a serious condition like prediabetes from progressing to type 2 diabetes can mean a better quality of life for program participants. This is both because diabetes itself is a serious and potentially fatal disease and because it often leads to other health problems.
How would preventing type 2 diabetes reduce financial costs?
Reducing the number of people getting type 2 diabetes would reduce its financial burden on individuals and the U.S. health care system. Direct medical costs for treating the nearly 26 million Americans with diabetes were $116 billion in 2007. Indirect costs, that include disability, work loss, and premature death, accounted for another $58 billion. Providing people with prediabetes with a cost-effective way to prevent type 2 diabetes can help people lead healthier lives, which would reduce health care costs.
What is the National Diabetes Prevention Program lifestyle curriculum?
The National Diabetes Prevention Program lifestyle training curriculum is based on the Diabetes Prevention Program (DPP). The DPP was a clinical research study led by the National Institutes of Health and supported by the Centers for Disease Control and Prevention.
Participant Notebook (Core) contains worksheets and handouts for participants to use in each of the 16 core sessions of the lifestyle intervention.
Participant Notebook (Post-Core) contains worksheets and handouts for participants to use in the post-core phase of the lifestyle intervention.
Lifestyle Coach Facilitation Guide (Core) step-by-step guide assists lifestyle coaches in facilitating each of the 16 core sessions of the lifestyle program.
Lifestyle Coach Facilitation Guide (Post-Core) is an annotated version of the post-core participant notebook that includes additional facilitation tips for lifestyle coaches.
Additional materials used by participants during the lifestyle intervention include the following:
Food and Activity Tracker log books are for participants to write down daily food intake, physical activity, and weight, which the lifestyle coach reviews to provide feedback to the participant. An example of this resource is My Game Plan [PDF–350 KB] from the National Diabetes Education Program.
Fat and Calorie Counter guides support a participants’ ability to track his or her daily fat grams and calorie consumption/intake. An example of this resource is Your Game Plan [PDF–405 KB] from the National Diabetes Education Program.
Get the curriculum and more information about the lifestyle change program on this Web site.
How does the lifestyle intervention help participants prevent type 2 diabetes?
Prediabetes means a person has a blood glucose (blood sugar) level that is higher than normal but not high enough to be classified as diabetes. The CDC estimates that more than one third of adult Americans and half of all adults aged 65 years and older have prediabetes. People with prediabetes have an increased risk of developing type 2 diabetes, that can lead to serious health problems like vision loss, lower limb amputations, and kidney disease. Although the statistics are alarming, tools are available to help manage diabetes and prevent new cases.
Studies have shown that people with prediabetes who lose a modest amount of weight (5 to 7 percent) and increase their physical activity to 150 minutes a week can prevent or delay the onset of type 2 diabetes. Participants in the program get help and support to make and sustain lifestyle changes needed to prevent type 2 diabetes. The National Diabetes Prevention Program is a 12-month program that has demonstrated effectiveness in improving the health of people with prediabetes. Participants meet in a group setting and learn about important changes that can help prevent type 2 diabetes like losing a modest amount of weight, being more physically active, and managing stress.
The National Diabetes Prevention Program teaches participants strategies for incorporating physical activity into daily life and eating healthy. Lifestyle coaches work with participants to identify emotions and situations that can sabotage their success, and the group process encourages participants to share strategies for dealing with challenging situations.
Participants aim to lose 5 to 7 percent of their body weight by reducing fat and calories, and by being physically active for 150 minutes a week (for a person weighing 200 pounds, the goal would be to lose 10 to 14 pounds.) Participants get useful information about eating nutritious foods, eating the right portion sizes, reading food labels, and adding physical activity. The group interaction during the 16-week core program is crucial to the program’s success. With a supportive group to cheer their successes and empathize with their setbacks, participants do not have to make lifestyle changes alone. The 6- month period after the core program is critical to the maintaining healthy lifestyle changes. Participants may have setbacks during this period but continue to work through these challenges with the help of the lifestyle coach and other group members by sharing successful ways to help stay focused and by reviewing curriculum content to reinforce continued positive strategies for maintaining healthy weight loss.
Who can offer lifestyle classes under the National Diabetes Prevention Program?
Any organization including the following:
- Not-for-profit and community-based organizations.
- Faith-based organizations.
- Educational institutions.
- Health care facilities.
- Fitness and wellness centers.
If an organization cannot offer the National Diabetes Prevention Program lifestyle intervention, can it still be involved in supporting diabetes prevention?
Yes. Organizations and individuals are needed to educate people about the program and refer participants to recognized sites. The organization may also help existing lifestyle intervention programs by offering financial support, providing meeting space, or assisting with other logistical or material requirements. Please contact the CDC for more information.
Where can my organization receive training to deliver the National Diabetes Prevention Program lifestyle intervention?
The Diabetes Training and Technical Assistance Center (DTTAC) of Emory University in Atlanta offers lifestyle coach training for organizations planning to offer the lifestyle intervention. DTTAC can provide fee-based lifestyle coach training for one to seven people in an organization, at its home in Atlanta, Georgia, or in a regional location. If the organization has 8 to 12 people interested in becoming lifestyle coaches, DTTAC will explore options for providing training at a location convenient to the group. For more information about cost of participating in the lifestyle coach training, please see the DTTAC Web site.
What is a lifestyle coach?
Lifestyle coaches are people trained to lead the lifestyle classes. A lifestyle coach is trained to use the National Diabetes Prevention Program curriculum (or an approved alternative curriculum) to help people with prediabetes prevent or delay developing type 2 diabetes. They need strong interpersonal and group facilitation skills. The responsibilities of a lifestyle coach include the following:
- Leading the lifestyle class sessions.
- Reviewing and providing feedback on the participant’s self-monitored eating and physical activity records.
- Weighing participant’s at each class.
Who can be a lifestyle coach?
Anyone who can meet the responsibilities spelled out above can be a lifestyle coach. However, a lifestyle coach must be affiliated with an organization supporting the delivery of the lifestyle intervention. For more information about training to become a lifestyle coach, please contact DTTAC. Details are available at DTTAC.
What is a master trainer?
Master Trainers are facilitators who are extensively trained in the National Diabetes Prevention Program Lifestyle Intervention curriculum (or an approved alternative curriculum). Master Trainers demonstrate in-depth knowledge of group dynamics, adult learning, and facilitation and are experts in training Lifestyle Coaches to deliver the Lifestyle Intervention.
Who can be a master trainer?
Master Trainers must have previous experience with a DPP-based lifestyle intervention or comparable facilitation experience, expertise in adult learning and group facilitation, and be familiar with the National Diabetes Prevention Program.
How can a department of health get involved in the National Diabetes Prevention Program?
State and local departments of health play an important role in disseminating the National Diabetes Prevention Program lifestyle intervention. This role includes the following:
- Raising awareness of prediabetes and the threat of type 2 diabetes.
- Describing the impact of type 2 Diabetes.
- Promoting the National Diabetes Prevention Program to stakeholders to increase use and referrals to the lifestyle intervention.
An overview of the National Diabetes Prevention Program is available on the CDC/DDT Web site.
Acronyms and abbreviations commonly used in these FAQs
CDC Centers for Disease Control and Prevention
DDT Division of Diabetes Translation (part of CDC)
DPP Diabetes Prevention Program (research study)
DTTAC Diabetes Training and Technical Assistance Center
Frequently used terms in these FAQs
Lifestyle class: The 16-session “core” and 6-session “post-core” classes attended by participants in the lifestyle intervention.
Lifestyle coach: Person trained to lead the National Diabetes Prevention Program lifestyle classes.
Participant: Person with prediabetes who is enrolled in a lifestyle class.
Prediabetes: A condition in which an individual has a blood glucose level higher than normal but not high enough to be classified as diabetes. A person with prediabetes has an increased risk of developing type 2 diabetes, heart disease, and stroke
Site: Physical location in which a lifestyle class meets.
PPHF 2012 - National Diabetes Prevention Program: Preventing Type 2 Diabetes Among People at High Risk Financed Solely by 2012 Prevention and Public Health Funds.
Pre-application Support Conference Calls for PPHF 2012
CDC held two 90-minute conference calls. A transcript and audio file of each call is available here:
June 28, 2012, 10:00 a.m.–11:30 a.m., EST
July 2, 2012, 5:00 p.m.–6:30 p.m., EST
Frequently Asked Questions
CDC posted FOA-related FAQs about the FOA during June 22 and July 25, 2012. Read and download the full text here: