Thursday, April 25, 2024

The Diabetes Prevention Program Services Are Commercially Reimbursed

The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) sponsored a study to determine if lifestyle changes could prevent or delay type 2 diabetes. The study was called the Diabetes Prevention Program (DPP) trial. The researchers concluded that a relatively small amount of weight loss, along with healthy eating and physical activity, can prevent or delay type 2 diabetes for people with prediabetes. Based on the trial's results, the National Diabetes Prevention Program, or National DPP, was started and led by the CDC. However, there was very little reimbursement by commercial insurers for the program. However, today, there are a number of commercial insurers reimbursing for the program.

The Diabetes Prevention Program or DPP trial was started in 1996. The trial ended in 2001. The trial was a randomized study consisting of three groups. One of the groups, called the Intensive Lifestyle Intervention group, used diet, exercise and lifestyle modification for the prediabetes treatment. One of the groups, called the Metformin group, used metformin for the treatment. And one of the groups was the Placebo group which was treated with usual care approaches. To be included in the trial, a person had to have a BMI of at least 24, except for Asian American, who needed a BMI of at least 22. Results from the study were reported in 2002.

The specific goal of the study was to determine if individuals with prediabetes could avoid type 2 diabetes by losing 7% of their weight through diet, exercise, and lifestyle modification. During the average 2.8-year period of the study's participants, it was concluded that the intensive lifestyle group experienced a 58% reduction in the incidence of type 2 diabetes, and that the metformin group experienced a 31% reduction, compared to the placebo group. And after ten years, the type 2 diabetes incidence "was reduced by 34% ... in the lifestyle group and 18% .. in the metformin group compared with placebo."

And Medicare did its own study to see if the National DPP services would benefit Medicare beneficiaries. The study did show that Medicare beneficiaries could benefit from the National DPP services, so Medicare started the Medicare DPP or MDPP in 2018, with reimbursement for the DPP services. And today, a number of commercial insurers are reimbursing for the National DPP.
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