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Low Use of Diabetes Prevention Activities Among At-Risk Adults

July 08, 2019

Participation in lifestyle modification programs to prevent diabetes is “exceedingly low” among US adults at risk of type 2 diabetes, according to a study published in JAMA Network Open.

Researchers came to the discovery through a nationally representative, population-based cross-sectional analysis of 50,912 respondents to the 2016 and 2017 National Health Interview Survey. Of the population represented, 36% had a diagnosis of prediabetes, an elevated American Diabetes Association risk score, or both.

“Individuals with prediabetes diagnoses were more likely than those without to receive diabetes risk–reduction advice and/or referrals by healthcare professionals,” researchers reported. “Advice and/or referral by a healthcare professional was associated with a higher likelihood of participation.”

Specifically, 73.5% of adults diagnosed with prediabetes reported receiving diabetes risk reduction advice or referrals to risk-reduction programs from a healthcare professional, according to the study. Between 35% and 75.8% said they went on to participate in the recommended activity or program.

Meanwhile, half of respondents with elevated diabetes risk scores but without a prediabetes diagnosis received risk-reduction advice or program referrals. Between 33.5% and 75.2% reported going on to engage in advised activities or programs.

Factors associated with engagement in risk-reduction efforts included receiving advice from a healthcare professional, age 45 to 64 years, higher educational attainment, health insurance status, gestational diabetes, hypertension, and obesity, according to the study.

“Among adults at high risk for diabetes, major gaps in receiving advice and/or referrals and engaging in diabetes risk-reduction activities and/or programs were noted,” researchers wrote. “These results suggest that risk perception, health care professional referral and communication, and insurance coverage may be key levers to increase risk-reducing behaviors in US adults.”

Jolynn Tumolo


Ali MK, McKeever Bullard K, Imperatore G, et al. Reach and use of diabetes prevention services in the United States, 2016-2017. JAMA Netw Open. 2019 May 3;2(5):e193160.

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