I CAN Prevent Diabetes! Individuals and Communities Acting Now to Prevent Diabetes Recruitment Discussion 2012

Partners Community Partners Healthcare  Community Clinic Host Agency  YMCA/ YWCA  Parks & Recreation  Faith Communities Local Public Health State Partners MDH  I CAN Prevent Diabetes!  Minnesota Diabetes Program

The Diabetes Epidemic: US Minority Populations  American Indians are almost 2 times more likely to develop diabetes compared to their non- Hispanic white counterparts.  Asian Americans, Hispanics, and non-Hispanic blacks are are also at increased risk CDC, National Diabetes Fact Sheet: US, 2011

The Diabetes Epidemic: US In the US, diabetes occurs in  16 % of American Indians  12 % of non-Hispanic Blacks  11 % of Hispanics  8 % of Asian Americans  7 % of non-Hispanic Whites CDC, National Diabetes Fact Sheet: US, 2011

The Diabetes Epidemic: MN In Minnesota  1 and 3 Adults have diabetes or prediabetes  375,000 have diabetes  147,000 of those do not know it  Greater than 1 million have prediabetes  Only 197,000 know they have prediabetes MDH, Minnesota Diabetes Fact Sheet: 2010

What is Prediabetes?  Blood glucose levels that are higher than normal, but not high enough to be called diabetes  Often precedes the development of type 2 diabetes –Can begin long-term damage to  Heart and circulatory system  Eyes and kidneys

Prediabetes  Increases the risk of developing  Type 2 diabetes  Heart disease  Stroke

Prediabetes Risk Factors  Age  Overweight or obese  High blood pressure  Abnormal lipid levels  Family history of type 2 diabetes  Ethnicity  History of gestational diabetes or 9+ lb baby  Inactivity American Diabetes Association

Clinical Criteria for Prediabetes ConditionTestResults Impaired Glucose Tolerance (IGT) 2-Hour Oral Glucose Tolerance Test 140–199 mg/dL Impaired Fasting Glucose (IFG) Fasting Plasma Glucose 100–125mg/dL After 8-hour fast Hemoglobin A1c Plasma Glucose % American Diabetes Association

Diabetes Can be PREVENTED!  Progression to diabetes is not inevitable!  Weight loss & increased physical activity can  Prevent or delay diabetes  May even return blood glucose levels to normal

I CAN Prevent Diabetes!  I CAN Prevent Diabetes is a collaborative, community-based, lifestyle change program designed for people with prediabetes. The Minnesota Individuals and Communities Acting Now (I CAN) Prevent Diabetes offers diabetes prevention education and support for people with prediabetes.  This program provides the tools to prevent or delay adult type 2 diabetes where you live.

I Can Prevent Diabetes! Will provide the following tools to help prevent/delay type 2 diabetes:  Resources on diabetes nutrition and preventative prediabetes physical activity  Training opportunities for I CAN PD program coaches  Instruction and coaching for diabetes prevention focused on nutrition and physical Activity  A 1 year program including an evidence-based 16 Week Class curriculum and 8 month post core activities  Strategies for involving people in community, work or clinic settings  Tips for partnering with other organizations in your community to defeat diabetes  Resources for promoting your program and tracking your progress  A diabetes prevention model that builds partnerships between Minnesota community health care providers, local fitness centers and public health officials

I CAN Prevent Diabetes!  Based on the results of the Diabetes Prevention Program

The Diabetes Prevention Program (DPP)  Diabetes Primary Prevention (DPP)  National, randomized, multisite study (published in 2002)  Participants = 3,234 overweight persons with prediabetes  Examined the effects of lifestyle change & pharmaceutical treatment on pre-diabetes  Lifestyle changes = diet & physical activity  Pharmaceutical = metformin* * Prescription medication that lowers blood glucose

Results from the DPP  DPP results showed*  Lifestyle intervention resulted in a 58% reduction in progression to diabetes compared to a placebo group  Seniors (60+ years) had a 71% reduction in the progression to diabetes compared to the placebo group  Medication intervention resulted in a 31% reduction  Findings were consistent across all ethnic groups, ages, and BMI subgroups * Diabetes Prevention Program Research Group. Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. New England Journal of Medicine 2002;346:

I CAN Prevent Diabetes: Program Details  Participant objectives  Attend all 16 weekly classes in designated community setting  Change unhealthy lifestyle behaviors  Increase activity  150minutes/week  Improve food choices  keep diary & follow fat gram goal  Lose weight, if overweight  5-7% of body weight  Attend post cores sessions offered monthly for 6-8 months

I CAN Prevent Diabetes: Getting Started Determine: Where I Can Prevent Diabetes will be implemented  Community Setting (YMCA, Faith Community, or Community Organizations)  Clinic Setting

I CAN Prevent Diabetes: Getting Started Determine: Who will be the Champion(s)  Who will attend Lifestyle Coach training  Who will be the Lifestyle Coach  Who will be part of the support team  How will team communicate with and support the Lifestyle Coach

I CAN Prevent Diabetes: Getting Started Determine: How participants will be recruited  Establish recruitment plan  Establish relationships between clinic and community organizations  Recruit community partners  Referrals  Labs

I CAN Prevent Diabetes: Getting Started Determine What data will be collected  Patients with pre-diabetes should be monitored for progression to diabetes every 6 months  Work with MDH to determine what data should be collected and submitted to MDH

I CAN Prevent Diabetes: Implementation Steps 1. Complete all getting started activities. 2. Send identified Lifestyle Coach(s) to an I CAN Prevent Diabetes for Sustaining Organizations – Lifestyle Coach Training offered by MDH. 3. Once Lifestyle Coach is trained, register program with I CAN Prevent Diabetes. 4. Once registered, implement I CAN Prevent Diabetes at your organization!

Importance of Prevention  National estimates  79 million people have pre-diabetes  Total cost of diabetes in US = $174 billion/ year  Minnesota estimates  Total cost of diabetes in MN = $2.6 billion/year  Diabetes prevalence has doubled in past 12 years  Diabetes is the 6th leading cause of death in Minnesota CDC, National Diabetes Fact Sheet: US, 2011 MDH, Minnesota Diabetes Fact Sheet: 2010

CDC Diabetes Prevention Recognition Program  CDC welcomes organizations that offer a lifestyle change program to prevent type 2 diabetes to apply for recognition by the Diabetes Prevention Recognition Program(DPRP)Diabetes Prevention Recognition Program(DPRP)  The purpose of the DPRP is to recognize programs that have shown that they can effectively deliver a lifestyle change program to prevent type 2 diabetes.

CDC Diabetes Prevention Recognition Program The DPRP has three key objectives:  To assure the quality, consistency, and broad dissemination of the lifestyle intervention.  To develop and maintain a registry of organizations that are recognized for their ability to deliver an effective lifestyle program to people at high risk for type 2 diabetes.  To provide technical assistance to organizations that have applied for recognition to help them deliver an effective lifestyle program and achieve and maintain recognition status.

CDC Diabetes Prevention Recognition Program For more information about becoming a recognized diabetes prevention program, visit:

Resources Centers for Disease Control & Prevention Diabetes Prevention Program Minnesota Department of Health actsheet.html American Diabetes Association diabetes/pre-diabetes-faqs.html

MDH Contact Rita Mays MN Diabetes Program Tammy Didion MN Diabetes Program Thank You!