Evaluation of a Workplace Diabetes Prevention Program Delivered via Distance Learning: A Qualitative Study.

Little is known about how distance learning impacts delivery of the National Diabetes Prevention Program (DPP) despite a rapid shift to this platform during the coronavirus disease 2019 (COVID-19) public health emergency. We explored how a workplace DPP, delivered via distance learning, impacted knowledge, motivation, and behavioral skills of participants throughout the program. We conducted repeated qualitative interviews with distance learning participants at baseline, 6 months, and 12 months from September 2020 to July 2022.

Trends and Race/Ethnic Disparities in Diabetes-Related Hospital Use in Medicaid Enrollees: Analyses of Serial Cross-sectional State Data, 2008-2017.

Background: Race/ethnic disparities in preventable diabetes-specific hospital care may exist among adults with diabetes who have Medicaid coverage.

Objective: To examine race/ethnic disparities in utilization of preventable hospital care by adult Medicaid enrollees with diabetes across nine states over time.

Design: Using serial cross-sectional state discharge records for emergency department (ED) visits and inpatient (IP) hospitalizations from the Healthcare Cost and Utilization Project, we quantified race/ethnicity-specific, state-year preventable diabetes-specific hospital utilization.

The Diabetes Prevention Gap And Opportunities To Increase Participation In Effective Interventions.

To understand the current state of prediabetes burden and treatment in the US, we examined recent trends in prediabetes prevalence, testing, and access to preventive resources. We estimated 13.5 percent prevalence of diagnosed prediabetes in the overall US adult population, using national survey data.

Estimating risk factor progression equations for the UKPDS Outcomes Model 2 (UKPDS 90).

Objectives: To estimate 13 equations that predict clinically plausible risk factor time paths to inform the United Kingdom Prospective Diabetes Study (UKPDS) Outcomes Model version 2 (UKPDS-OM2).

Methods: Data from 5102 UKPDS participants from the 20-year trial, and the 4031 survivors with 10 years further post-trial follow-up, were used to derive equations for the time paths of 13 clinical risk factors: HbA , systolic blood pressure, LDL-cholesterol, HDL-cholesterol, BMI, micro- or macro-albuminuria, creatinine, heart rate, white blood cell count, haemoglobin, estimated glomerular filter rate, atrial fibrillation and peripheral vascular disease (PVD). The incidence of events and death predicted by the UKPDS-OM2 when informed by the new risk factor equations was compared with the observed cumulative rates up to 25 years.

Co-occurrence of diabetes and depression in the U.S.

Evidence exists that depression interacts with physical illness to amplify the impact of chronic conditions like diabetes. The co-occurrence of these two conditions leads to worse health outcomes and higher healthcare costs. This study seeks to understand what demographic and socio-economic indicators can be used to predict co-occurrence at both the state and the individual level.

How Much Does Attendance Impact Weight Loss and Health Care Spending in a Diabetes Prevention Program Serving Older Adults?

Purpose: Measure attendance to the Young Men's Christian Association (YMCA) of the USA (Y-USA) diabetes prevention program (DPP) and show how attendance impacts weight loss and medical spending in a population of Medicare beneficiaries.

Design: Observational study using a pre- and post-specification.

Setting: A total of 17 participating YMCAs nationwide.

Impact of Financial Incentives on Service Use, Spending, and Health in Medicaid.

Introduction: The Centers for Medicare and Medicaid Services provided grants to Medicaid programs through the Medicaid Incentives for Prevention of Chronic Diseases program to test whether financial incentives changed the use of healthcare services, Medicaid spending, and health outcomes. Six states implemented programs related to diabetes prevention, weight management, diabetes management, and hypertension management. The purpose of this study is to examine whether receipt of financial incentives increased use of services incentivized by the program; reduced expenditures, inpatient admissions, emergency department visits; and improved health outcomes.

State-level diabetes-attributable mortality and years of life lost in the United States.

Purpose: To estimate state-level diabetes-attributable deaths and years of life lost (YLL) in the Unites States.

Methods: We estimated diabetes-attributable all-cause and cardiovascular disease (CVD) deaths by age, sex, and state, using the attributable fraction approach. Data on diabetes prevalence were collected from Behavioral Risk Factor Surveillance System.

Impact of Financial Incentives on Diabetes Prevention Class Attendance and Program Completion: Evidence From Minnesota, Montana, and New York.

Purpose: To test the role of financial incentives to motivate engagement in diabetes prevention programs (DPPs).

Design: Minnesota, Montana, and New York randomized 3 different approaches to providing incentives: incentivizing class attendance and weight loss (all states), class attendance only (NY), and weight loss only (NY). We used New York to test how different approaches to providing incentives influence DPP completion and attendance.

Medicaid Incentives for Preventing Chronic Disease: Effects of Financial Incentives for Smoking Cessation.

Objective: To test the effectiveness of financial incentives for smoking cessation in the Medicaid population.

Data Sources: Secondary data from the Medicaid Incentives for Prevention of Chronic Disease (MIPCD) program and Medicaid claims/encounter data from 2010 to 2015 for five states.

Study Design: Beneficiaries were randomized into receipt or no receipt of financial incentives.

A Review of the Impacts of Different Approaches for Diabetes Prevention and a Framework for Making Investment Decisions.

This paper selectively reviews the economic research on individual (i.e., diabetes prevention programs and financial rewards for weight loss) and population-wide based diabetes prevention interventions (such as food taxes, nutritional labeling, and worksite wellness programs) that demonstrate a direct reduction in diabetes incidence or improvements in diabetes risk factors such as weight, glucose or glycated hemoglobin.

Identifying risk for type 2 diabetes in different age cohorts: does one size fit all?

Objective: To estimate age-specific risk equations for type 2 diabetes onset in young, middle-aged, and older US adults, and to compare the performance of simple equations based on readily available demographic information alone, against enhanced equations that require both demographic and clinical information (fasting plasma glucose, high-density lipoprotein, and triglyceride levels).

Research Design And Methods: We estimated the probability of developing diabetes by age group using data from the Coronary Artery Risk Development in Young Adults (for ages 18-40 years), Atherosclerosis Risk in Communities (for ages 45-64 years), and the Cardiovascular Health Study (for ages 65 years and older). Simple and enhanced equations were estimated using logistic regression models, and performance was compared by age group.

Health selection into neighborhoods among patients enrolled in a clinical trial.

Health selection into neighborhoods may contribute to geographic health disparities. We demonstrate the potential for clinical trial data to help clarify the causal role of health on locational attainment. We used data from the 20-year United Kingdom Prospective Diabetes Study (UKPDS) to explore whether random assignment to intensive blood-glucose control therapy, which improved long-term health outcomes after median 10 years follow-up, subsequently affected what neighborhoods patients lived in.

A Feasibility Study of Supply and Demand for Diabetes Prevention Programs in North Carolina.

Introduction: Diabetes Prevention Programs (DPPs) have shown that healthy eating and moderate physical activity are effective ways of delaying and preventing type 2 diabetes in people with impaired glucose tolerance. We assessed willingness to pay for DPPs from the perspective of potential recipients and the cost of providing these programs from the perspective of community health centers and local health departments in North Carolina.

Methods: We used contingent valuation to determine how much potential recipients would be willing to pay to participate in DPPs under 3 different models: delivered by registered professionals (traditional model), by community health workers, or online.

Impact Of The YMCA Of The USA Diabetes Prevention Program On Medicare Spending And Utilization.

The YMCA of the USA received a Health Care Innovation Award from the Centers for Medicare and Medicaid Services to provide a diabetes prevention program to Medicare beneficiaries with prediabetes in seventeen regional networks of participating YMCAs nationwide. The goal of the program is to help participants lose weight and increase physical activity. We tested whether the program reduced medical spending and utilization in the Medicare population.

The effect of diabetes complications on health-related quality of life: the importance of longitudinal data to address patient heterogeneity.

We estimate the impact of six diabetes-related complications (myocardial infarction, ischaemic heart disease, stroke, heart failure, amputation and visual acuity) on quality of life, using seven rounds of EQ-5D questionnaires administered between 1997 and 2007 in the UK Prospective Diabetes Study. The use of cross-sectional data to make such estimates is widespread in the literature, being less expensive and easier to collect than repeated-measures data. However, analysis of this dataset suggests that cross-sectional analysis could produce biased estimates of the effect of complications on QoL.

Adenosine receptor antagonism in acute tacrolimus toxicity.

Background: Calcineurin inhibitors induce renal vasoconstriction and oliguria during acute toxicity. We previously demonstrated that the non-specific adenosine receptor antagonist theophylline improved glomerular filtration rate (GFR) and renal blood flow in the setting of acute tacrolimus (TAC) toxicity. This study was undertaken to determine which of the known adenosine receptor subtypes is responsible for the observed effect of theophylline.