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Patient-Centered Goal-Setting in the National Diabetes Prevention Program: A Pilot Study
Natalie D Ritchie1,2,3, Katherine A Sauder4,5, Peter G Kaufmann6
1Office of Research, Denver Health and Hospital Authority, Denver, CO natalie.ritchie@dhha.org.
Diabetes Care
|August 18, 2021
Summary
A flexible National Diabetes Prevention Program (NDPP) adaptation improved blood sugar control (HbA1c) in participants at risk for diabetes. This patient-centered approach, focusing on tailored goals, shows promise for better glycemic outcomes.
Area of Science:
- Health Behavior Change
- Diabetes Prevention
- Metabolic Health
Background:
- The standard National Diabetes Prevention Program (NDPP) faces challenges with participant retention and achieving preset goals, potentially limiting its benefits.
- Difficulty meeting strict targets for weight loss and physical activity can lead to dropout in traditional NDPP programs.
Purpose of the Study:
- To pilot a patient-centered adaptation of the NDPP (NDPP-Flex) designed with flexible, individually tailored goals to improve participant retention and health outcomes.
- To evaluate the effectiveness of NDPP-Flex compared to the standard NDPP in diverse participants at risk for diabetes.
Main Methods:
- A pilot study compared NDPP-Flex (n=95) with standard NDPP (n=245) over one year, assessing retention, physical activity, weight loss, and glycated hemoglobin (HbA1c).
- Participants in the pilot received NDPP-Flex with weekly adjustable goals, while the comparison group received the standard NDPP curriculum.
- The study design was non-randomized, with NDPP-Flex cohorts starting in 2018 and standard NDPP cohorts launching between 2016 and 2017.
Main Results:
- Retention, physical activity levels, and weight loss were similar between the NDPP-Flex and standard NDPP groups.
- NDPP-Flex participants demonstrated significantly greater reductions in HbA1c compared to the standard NDPP group (0.22% vs. 0.06%).
- Participants in the NDPP-Flex program were more likely to achieve normoglycemia (normal blood sugar levels) at follow-up.
Conclusions:
- An adapted, patient-centered NDPP focusing on flexible, self-selected goals is a promising strategy for improving glycemic control.
- This approach may enhance diabetes risk reduction even without significant weight loss.
- Tailoring goals and offering flexibility can potentially improve health outcomes in diabetes prevention programs.
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