Modeling the Impact of Combined Individual and Population-Level National Strategies for Preventing Type 2 Diabetes

Preventive strategies for Type 2 diabetes include interventions aimed at modifying population-level risk factors and interventions targeting individuals at an elevated risk. However, the combined national impact of these approaches has not been quantified.

This study used a simulation model to estimate the number of incident Type 2 diabetes cases and diabetes-related complications that could be prevented over 10 years by implementing evidence-based, combined preventive strategies. These included population-level sugar-sweetened beverage reduction interventions and individual lifestyle intervention programs for adults with elevated glycemic risk (HbA1c 5.7%-6.5%). Two scenarios were evaluated: (1) a moderate strategy involving a 13% reduction in sugar-sweetened beverage consumption and an online lifestyle intervention and (2) an intensive strategy involving a 55% reduction in sugar-sweetened beverage consumption and an in-person lifestyle intervention. A nationally representative cohort of U.S. adults without diagnosed diabetes was constructed using data from the 2013-2018 National Health and Nutrition Examination Survey.

The moderate strategy was projected to prevent 3.7% (562,546) of new Type 2 diabetes cases over 10 years, whereas the intensive strategy would prevent 12.8% (1,958,164). The number of diabetes-related complications prevented generally aligned with the reduction in incident Type 2 diabetes cases. Across different scenarios, of the total cases prevented, 64%-98% were attributable to the sugar-sweetened beverage reduction.

These findings demonstrate the potential national impact of integrating population-level strategies to reduce sugar-sweetened beverage consumption and a targeted Diabetes Prevention Program intervention to reduce the incidence of Type 2 diabetes and its complications.