Diabetes in American Adults and The National Diabetes Prevention

Program/Lifestyle Change Program

Diabetes in American Adults and The National Diabetes

Prevention Program/Lifestyle Change Program
Roxana Lievanos
Health 405: Fundamentals health Education
Final Paper
California State University, Channel Islands
Spring 2020

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Diabetes in American Adults and The National Diabetes Prevention
Program/Lifestyle Change Program

Diabetes is a chronic disease that’s affects many American adults. There

are currently 26.8 million adults in the United States living with diagnosed

diabetes. It is also listed as the seventh leading cause of deaths in the U.S. The

number of adults diagnosed with diabetes has doubled in the past twenty years

as a result of the American population aging and becoming overweight or obese

(CDC, 2019). Diabetes is a continuing health issue that poses a threat to many

Americans, and with initiatives such as The National Diabetes Prevention

Program we can help combat this problem with the curriculum provided

through its Lifestyle Change component.

Diabetes is a disease that prevents the body from processing glucose

therefor raising glucose levels. This occurs when the body cannot create or use

insulin. Insulin is a hormone that is created in the pancreas and aids in turning

glucose to energy. Glucose then remains in your blood and is unable to reach

cells. A high level of glucose in the blood is referred to as hyperglycemia. This is

key indicator of diabetes.

Living with diabetes is challenge as it can lead to additional health

problems. The risk of this disease also increases with age. Diabetes is the number

one cause of kidney failure, lower-limb amputations, and adult blindness (CDC,

2020). It may also increase your chance of developing dementia, cancer, and

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Diabetes in American Adults and The National Diabetes Prevention
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depression. Developing any of these conditions can cause diabetes management

to become more difficult.

There are three main types of diabetes. They are type 1 diabetes, type 2

diabetes, and gestational diabetes. Type 1 diabetes can develop at any age, but is

commonly found among children and adolescents. This form of diabetes results

from the autoimmune destruction of the pancreas’s beta cells, which produce

insulin (Bullard, K.M., 2018). Type 2 diabetes is the form that is most common in

adults. This accounts for around 90% of all diabetes cases (International

Diabetes Federation, 2020). Type 2 diabetes is mainly caused by a combination

of insulin resistance and relative insulin deficiency (Bullard, K.M., 2018). Other

contributing factors in developing type 2 diabetes are obesity, physically

inactive, and family history. The third type of diabetes is gestational diabetes,

which affects women during pregnancy. This may cause complications to the

mother and child, however this form of diabetes can disappear after pregnancy.

Family history is also a contributor to developing gestational diabetes. Diabetes

can also be caused by genetic mutations, hormonal disease, certain medicines,

and damage to the pancreas. There is also prediabetes, this is when blood

glucose levels are higher than normal yet are not high enough to declare a

diabetes diagnoses.

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Diabetes in American Adults and The National Diabetes Prevention
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There are many Americans who are not familiarized with the symptoms

associated with diabetes. For this reason, many may go undiagnosed over a long

period of time. Early treatment and diagnoses is crucial. Untreated diabetes can

lead to severe health problems. Symptoms of diabetes include excessive thirst,

excessive urination, vision changes, and weight loss. Another associated

symptom is the inability for wounds to heal quickly. As a result, those with

diabetes may suffer from frequent infections.

This health issue is of great concern as the prevalence rates continue to

increase. This increase is seen significantly among those who are Alaska Natives,

Native American, Black, and Hispanic. I personally know many who have been

affected by this disease and for this reason support any efforts taken to combat

this problem. As a Hispanic adult, the chances of acquiring diabetes later in my

life are high. It is estimated that 50% of Hispanic adults in the United States are

expected to develop type 2 diabetes (Bauer, M.R., 2017). In the United States

12.5% of Hispanics, 14.7% of American Indian/ Alaska Natives, 11.7% of non-

Hispanic blacks, 9.2% of Asian Americans, and 7.5 % of non-Hispanics are

diagnosed with diabetes. In addition, Americans aged 65 and older have a high

prevalence rate at about 26.8% (American Diabetes Association, n.d).

In 2015, 88 million American adults had prediabetes. One in four people

are unaware they have diabetes. Every year there are also 1.5 million new cases

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Diabetes in American Adults and The National Diabetes Prevention
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of diabetes. As previously mentioned, diabetes is the seventh leading cause of

death in the U.S. It accounts for 79,000 deaths annually (Americas Health

Rankings, n.d). Studies project an increase in diabetes. It is projected that in

2060 there will be 60.6 million Americans living with diabetes. Projections also

were made among those 65 and older, and it is estimated that by 2060 there

would be 35.2 million diagnoses in this population. This increase is projected

among all races and sex groups (Lin, J., 2018)

Extensive efforts have been in effect to combat the ongoing diabetes

health problem. Many organizations have also been developed to provide

resources to help educate and provide information to Americans on diabetes.

Some of these organizations include The American Diabetes Association,

Hormone Health Network, Diabetes Advocacy Alliance, and Centers for Disease

Control: Division of Diabetes Translation. The CDC’s Division of Diabetes

translation funds state, local health departments and national organizations to

support programs and activities to prevent or delay the onset of type 2 diabetes

and improve health outcomes for people diagnosed with diabetes( CDC, 2020).

A program that has shown to be beneficial in fighting diabetes is the

National Diabetes Prevention Program, which was established by the CDC in

2010. Partnerships were developed amongst public and private organizations to

help combat the growing prediabetes and type 2 diabetes problem in the United

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Diabetes in American Adults and The National Diabetes Prevention
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States. Federal agencies, state and local health departments, employers, public

and private insurances, and health care professionals are some of the public and

private organizations who have partnered with the National DPP. This program

provides a framework for diabetes prevention. The National Diabetes

Prevention Program aims to prevent diabetes by making lifestyle changes.

A key component of the National DPP is the Lifestyle Change Program. This

program is designated for those who have prediabetes or are at risk for type 2

diabetes. This component is designed for participants to develop healthier eating

habits, increase physical activity, and improve coping skills. Studies show that

changing these behaviors helped people with prediabetes lose 5% to 7% of their body

weight and reduce their risk of developing type-2 diabetes by 58% (71% for people

over 60 years old) (CDC, n.d). Those who wish to participate in the Lifestyle Program

may do so by attending in person group sessions or access it online. Combinations of

both online and in person program sessions are also available . The curriculum can

also be provided in Spanish. Cost for this program differs from location and

organization. However, there are some insurances or employers who may cover any

costs related to the program.

A lifestyle coach teaches the curriculum. This curriculum is delivered over the

course of a year and is divided into two phases. The first phase, offers 16 sessions

over 16-24 weeks. During this phase those partaking in this program learn how to

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Diabetes in American Adults and The National Diabetes Prevention
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improve their eating habits without depriving themselves of their favorite foods.

Implementation of physical activity into ones daily life is taught during this phase as

well. In this phase participants also discover methods on how to deal with stress and

ways to cope with challenges that may disrupt any progress made. A topic is covered

in each session. Therefore a total of sixteen topics are covered in phase one.

Furthermore, examples of the topics covered in phase one that address these

objectives are tip the calorie balance, move those muscles, talk back to negative

thoughts, and make social cues work for you, just to name a few. The second phase

offers one session a month. This phase is designated to help strengthen all the skills

you learned in phase one. The second phase has a total of fourteen topics. Some

examples of these topics include balance your thought for long-term maintenance,

preventing relapse, and staying on top of physical activity (CDC, n.d).

Those who wish to participate in a Lifestyle Change program must meet certain

requirements. To be eligible one must be 18 years or older and be overweight. A

individual is considered overweight if their body mass index is be above 24, or if Asian,

22. An additional criterion that must be met is that a diagnosis of type 1 diabetes or type

2 diabetes has not been declared. Participants also should not be pregnant. All the

requirements must be met as well as one of the following, results of a recent blood test

fall within the prediabetes range; a doctor has formerly given you a gestational diabetes

diagnoses, or you have received a test result stating you are at high risk for diabetes CDC,

2020)

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Diabetes in American Adults and The National Diabetes Prevention
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The ultimate goal of The National Diabetes prevention program is to be able to

delivery its program nationwide all while providing quality and adherence to

proper standards. It also strives to train community organizations that can run the

lifestyle change program effectively. In addition, increase referrals to and

participation in CDC-recognized lifestyle change programs, and increase coverage by

employers and public and private insurers (CDC, 2018). Participants have shared their

experiences and expressed how significant it has been in improving their overall

health. Jan Brooker, a participant in the program states “ This program has taught me

how to eat healthy and find an exercise routine that works for my schedule”.

The National Diabetes Prevention Program is beneficial and has proven to be

effective in reducing diabetes in Americans. However, I do believe more efforts

should be made to increase the number of participants in underserved areas. In 2017

the CDC established the 1705 cooperative agreement, which provides funding to

organizations. With this funding organizations can delivery the diabetes prevention

program. Although this agreement is helpful, additional actions are required. Through

community based participatory research we can determine what are the needs in this

population so that they can be addressed. Addressing these needs will then increase

the number or participants from underserved areas. Analyses of the usefulness of

CBPR have shown that collaboration among community members, researchers,

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Diabetes in American Adults and The National Diabetes Prevention
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providers and patients can lead to improvement in the overall health of a variety of

communities and lessen health disparities (Tapp, H., 2013).

Many Americans are affected by diabetes. They are affected by type 1

diabetes, type 2 diabetes and gestational diabetes. There are also many Americans

who fall with in the prediabetic range. A late diagnosis can be very detrimental to

ones health and cause additional illnesses. Those who are Hispanic, American

Indian/ Alaska Natives, and non-Hispanic blacks have the highest rate of

diagnosed diabetes. For this reason preventative measures must be taken to

reduce it’s prevalence. The National Diabetes Prevention Program through its

Lifestyle Change program can help achieve this. The curriculum offered has

scientifically proven that this program is effective through its yearlong delivery.

The National DPP continues to increase its enrollment rate. However, more can

be done to increase enrollment amongst those living in underserved areas.

Through extensive efforts, such as The National DPPs Lifestyle Change program

we can help fight against the prevalence of diabetes and improve the overall

wellness of Americans. As program participant Cynthia Johnson said “ Its not

about how long you live: its about how well you live”.

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Diabetes in American Adults and The National Diabetes Prevention
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References

American Diabetes Association. (n.d.). Statistics About Diabetes. Retrieved from

https://www.diabetes.org/resources/statistics/statistics-about-diabetes

American health rankings. (n.d.). Diabetes: Annual Report. Retrieved from

https://www.americashealthrankings.org/explore/annual/measure/Diabetes/state/ALL

Bauer, M. R. (2017, November 7). Why Hispanics Are at a Higher Risk of Type 2
Diabetes: Everyday Health. Retrieved from https://www.everydayhealth.com/type-2-
diabetes/living-with/why-hispanics-are-higher-risk-type-2-diabetes/

Bullard, K. M., Cowie, C. C., Lessem, S. E., Saydah, S. H., Menke, A., Geiss, L. S.,
Orchard, T. J., Rolka, D. B., & Imperatore, G. (2018). Prevalence of Diagnosed
Diabetes in Adults by Diabetes Type - United States, 2016. MMWR. Morbidity and
mortality weekly report, 67(12), 359–361. https://doi.org/10.15585/mmwr.mm6712a2

CDC. (n.d.). National DPP Customer Service Center. Retrieved from

https://nationaldppcsc.cdc.gov/s/aboutus

CDC. (n.d.). Curriculum for CDC-Recognized Diabetes Prevention Lifestyle Change

Programs . Retrieved from
https://www.cdc.gov/diabetes/prevention/pdf/Curriculum_TOC.pdf

CDC. (2018, December 11). What Is the National DPP? Retrieved from
https://www.cdc.gov/diabetes/prevention/what-is-dpp.htm

CDC. (2019, August 6). Diabetes Quick Facts. Retrieved from

https://www.cdc.gov/diabetes/basics/quick-facts.html

CDC. (2020, March 11). What is diabetes? Retrieved from

https://www.cdc.gov/diabetes/basics/diabetes.html

CDC. (2020, March 17). Lifestyle Change Program Details. Retrieved from
https://www.cdc.gov/diabetes/prevention/lcp-details.html

CDC. (2020, April 7). State, Local, and National Partner Diabetes Programs.
Retrieved from https://www.cdc.gov/diabetes/programs/stateandlocal/index.html

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Program/Lifestyle Change Program

International Diabetes Federation. (2020, March 26). What is Diabetes. Retrieved

from https://www.idf.org/aboutdiabetes/what-is-diabetes.html

Lin, J., Thompson, T.J., Cheng, Y.J. et al. Projection of the future diabetes burden in
the United States through 2060. Popul Health Metrics 16, 9 (2018).
https://doi.org/10.1186/s12963-018-0166-4

Tapp, H., White, L., Steuerwald, M., & Dulin, M. (2013). Use of community-based
participatory research in primary care to improve healthcare outcomes and disparities
in care. Journal of comparative effectiveness research, 2(4), 405–419.
https://doi.org/10.2217/cer.13.45

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