Purpose: According to the Centers for Disease Control (CDC), one-third of adults have prediabetes and are at risk for developing type 2 diabetes, a leading risk factor for cardiovascular disease. The Diabetes Prevention Program (DPP) focuses on lifestyle modifications to help participants lose 5-7% of their body weight and prevent type 2 diabetes. The purpose of this study is to determine whether successful completion of the DPP is associated with a decrease in atherosclerotic cardiovascular disease (ASCVD) risk.
Methods: One-site, prospective cohort study. The DPP was implemented on-site at Farmington Village Family Practice and virtually via Zoom from January 2020 through December 2020. For the first 6 months, participants met weekly for 1 hour. In the remaining 6 months, sessions were held monthly for 1 hour. Each session began with a private weigh-in followed by a uniquely designed lesson plan. Fourteen patients who were prediabetic based on hemoglobin A1c(A1c), fasting blood glucose, or diabetic risk score calculator. Systolic blood pressure (SBP), diastolic blood pressure (DBP), smoking status, anti-hypertensive medications, age, race, sex, hemoglobin A1c, fasting blood glucose, total cholesterol and HDL were measured initially, at six months and at one year. These parameters were used to calculate ASCVD risk percentages based on the 2013 risk calculator from AHA/ACC.
Results: The 6-month analysis showed a statistically significant improvement in ASCVD (mean initial 2.00, mean reduction 0.74, p < 0.001), SBP (mean initial SBP 129, mean reduction of 6.571 mmHg, p < 0.001), weight (mean initial weight 262 lbs, mean reduction of 24.643 lbs, p = 0.003), and HDL (mean initial HDL 40.86, mean increase of 7.143, p = 0.001). These data points will also be analyzed at the completion of the study.
Conclusions: After 6 months of the DPP program, statistically significant improvements in ASCVD, SBP, HDL and weight were observed. Once the data is collected with regards to twelve-month vitals and lab values, a similar statistical analysis will be performed. The findings at the six-month mark are promising and are consistent with the reduction of cardiovascular risk factors. These interim findings further support the value of a structured, evidence-based educational curriculum focused on nonpharmacologic intervention for cardiovascular risk reduction.
Kucera M, Marchewka T, Craib A. Does Losing 5-7% of a Prediabetic’s Body Weight While Completing the Diabetes Prevention Program Decrease ASCVD Risk? Presented at Society of Teachers of Family Medicine. Virtual 2021 Annual Spring Conference. May 3, 2021.