opinion: personalized prevention programs are key to reducing the risk of type 2 diabetes
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individuals at risk of type 2 diabetes need more than general information about diet, exercise and weight loss. they need a program that marries general information with individualized coaching.
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while covid, bird flu, mpox and measles have dominated health headlines recently, another health crisis has lurked in the background, threatening millions in canada.
close to six million canadians have diabetes and millions more are at risk of developing it, particularly type 2, the most common form. the chronic disease not only poses significant health risks for those who have it—it is the seventh leading cause of death in canada and it also costs our healthcare system close to $30 billion a year to treat.
the situation will only worsen as canada’s population ages and grows unless we adopt effective prevention strategies. a promising solution lies in personalized prevention programs that empower individuals to make sustainable lifestyle changes that lower their risk of developing type 2 diabetes.
preliminary results from a recent canadian diabetes prevention program (cdpp) trial show how effective these types of programs can be.
while there are some risk factors for type 2 diabetes that individuals cannot change—including aging and genetic factors—there are others, such as diet, exercise and weight, that they can control.
the cdpp study examined whether a 12-month digital program using one-on-one health coaching, group education workshops and health tracking could help high-risk individuals adopt a healthier lifestyle that prevented or delayed the onset of type 2 diabetes.
the study was done in collaboration with lmc healthcare, diabetes canada, intervent and boehringer ingelheim canada, with funding from the public health agency of canada (phac).
the cdpp enrolled 2,133 adults who had been diagnosed with prediabetes—where blood glucose levels are higher than normal, but not high enough to meet the type 2 diabetes threshold—or were at high risk of developing diabetes based on phac’s diabetes risk questionnaire canrisk or because they were 45 years or older with a body mass index of at least 30 kg/m2.
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each participant was assigned a qualified personal health coach, who delivered individualized coaching online or via telephone. group education workshops were provided online, allowing individuals to take part at their convenience.
education modules focused on topics such as healthy eating, physical activity, losing weight and managing stress. participants received personalized meal and exercise plans and tools to track their eating, exercise and weight. challenges and incentives were also included to motivate them.
health measurements taken at the beginning of the study and at the 12-month mark showed that participants made significant improvements over the course of the program.
blood glucose levels went down for approximately 81 per cent of participants. the number of participants without prediabetes rose, with data showing an 87 per cent relative increase in the number of people who did not have prediabetes or diabetes compared to the start of the program.
the data also showed significant weight loss and reduced waist sizes for participants at the 12-month follow up. participants also reported doing more exercise and eating more vegetables.
the canadian program’s modules were adopted online from a similar study in the united states, where participants receiving an in-person intervention reduced the risk of developing type 2 diabetes by 58 per cent for those with prediabetes. a 10-year follow-up of this u.s. study found that the participants who received the lifestyle intervention were still one-third less likely to develop type 2 diabetes than the non-intervention group.
individuals at risk for diabetes are often on their own when it comes to making lifestyle changes. primary health care providers—already stretched thin—might not always have the time or resources to develop a personalized plan for each patient at risk.
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while broad-brush prevention programs exist, individuals at risk need more than general information about diet, exercise and weight loss. they need a program that marries general information with individualized coaching and health tracking to empower them to make the changes specific to their needs.
while there are effective drug treatments for type 2 diabetes, the serious health complications of the disease and the high costs of treating them underscore the need to prioritize prevention.
and while some might look to weight-loss drugs as a way to stave off a risk factor for type 2 diabetes, personalized diabetes prevention programs offer a more comprehensive approach without the sometimes serious side effects of the drugs.
evidence shows that personalized diabetes prevention programs can play an important role in preventing or delaying the onset of type 2 diabetes. it is time to invest in them. an ounce of prevention really is worth a pound of cure.
dr. harpreet bajaj is medical director of endocrine and metabolic research at lmc healthcare and the principal investigator of the cdpp.
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