Development of the Lifestyle Empowerment Approach for Diabetes Remission (LEADR) Program: A Lifestyle Medicine Shared Medical Appointment (SMA) Intervention for Diabetes Treatment

The use of shared medical appointments (SMAs) has been shown to be feasible for delivering lifestyle medicine (LM) treatment for chronic conditions, such as type 2 diabetes (T2D), with some patients achieving de-escalation of medications or even remission. This objective of this work was to develop program materials suitable for delivering intensive LM treatment for T2D with the goal of achieving remission. Over a 3-year period (2022-2025), the American College of Lifestyle Medicine (ACLM) engaged in iterative development of program materials, drawing on content in the Full Plate Living Program and using expertise from a variety of professionals including physicians, dietitians, and researchers. The resulting Lifestyle Empowerment Approach for Diabetes Remission (LEADR) Program includes a professionally designed Facilitator Script, Participant Workbook, and Planning Guide, as well as accompanying slides. The core program content consists of 12 ∼90-minute, weekly sessions billable using standard Evaluation and Management (E&M) codes. Content centers on health behavior education and SMART goal-setting for nutrition, physical activity, and other health behaviors. The LEADR program is available as a tool for providers and their healthcare teams to use in the treatment of patients with T2D and prediabetes; the structure and formatting of the content enable scalability across various settings.