of type 2 in people at high risk. “The
conventional wisdom at the time
was that weight loss isn’t effective”
in combating type 2, says David Marrero, PhD, professor of medicine at
Indiana University and a member
of the Diabetes Forecast editorial
board. Marrero and collaborators
put together a large study (also called
the Diabetes Prevention Program)
to answer once and for all whether
lifestyle changes could help fend off
type 2. The DPP results, published in
2002, were a big success (box, right).
“Lifestyle change became the most
potent method to prevent or delay the
onset of diabetes in high-risk people,”
says Marrero. Then the question
became how to bring the program to
the people who need it.
effectively at a reasonable cost. The
original DPP was too expensive for
broad access, at $1,400 a year per par-
ticipant. The Y program has cut costs
dramatically by offering group classes
and by training community mem-
bers as lifestyle coaches to teach the
course. The new way of delivering
the DPP is getting results as good as
the original—at a quarter of the cost.
Plus, the coaches can bring the YDPP
to locations beyond the 47 metro area
YMCAs that now offer it. “We can
come to where you are,” says Irmina
Ulysse, the program’s director for the
YMCA of Metropolitan Washington.
“We just need 15 people and a spot.”
The Next Steps
The YDPP and similar efforts are
now part of a grander scheme called
the National Diabetes Prevention
Karen Robinson, 64, recently graduated from a DPP class at a local Y
in the Washington, D.C., area. She
signed up after her doctor said she
would need to take medication for
her prediabetes. “That got my attention, because the last thing I want to
do is take another pill,” she says.
By the end of the four-month program, she’d reached her goal weight.
The DPP gave Robinson the tools to
make healthy eating decisions. “I’ve
learned that when I go to my favorite
restaurant a couple of times a year, to
maybe get a smaller-size [crab cake]
and have green beans instead of a
baked potato,” she says.
The program works because it’s
logical, says DPP researcher Marrero.
“It’s not a diet. It’s a way to approach
how you eat and incorporate food and
physical activity into your life.”
The YMCA’s course, known as
the YDPP, is delivering the program
THE 7 PERCENT SOLUTION
the diabetes prevention program study had people with prediabetes meet
one-on-one with health care providers in clinical settings. the goal: to lose
7 percent of their body weight by changing their approach to food and exercise.
the 16-week program included weekly one-hour sessions on topics such as
reading food labels, dealing with stress without overeating, and increasing
physical activity to 150 minutes a week. Monthly refresher sessions helped
maintain results. dpp participants:
lost an average of 5 percent of their body weight.
lowered their risk of developing diabetes by 58 percent compared
with a control group.
From left, Sandi hunter, Karen robinson, and belen bryant are graduates of the
diabetes prevention program at their local y.