For patients living with prediabetes, expert coaching and peer support for lifestyle changes are effective tools to prevent a diabetes diagnosis.
UTMB Health’s diabetes prevention program, called PreventT2®, has successfully implemented this approach since 2017. In 2019, the program received Full Recognition from the Centers for Disease Control and Prevention (CDC), and in 2021, it achieved a new distinction of Full Plus Recognition for its distance learning modality – an impressive feat considering that major formatting changes were necessitated by the COVID-19 pandemic.
“We had an in-person program, but due to the public health emergency, we switched it up to be distance learning. And we did the switch in one month,” says Hanaa Sallam, MD, PhD, CDCES, Co-PI and Director of the Diabetes Prevention Program and a Certified Lifestyle Coach. “Many institutions actually stopped the program and didn’t continue, but we knew that there is a need. We couldn’t leave our patients.”
What Dr. Sallam and PI, Hani Serag, MD, MPH, found was that participation did not drop off when the pandemic disrupted people’s lives – it actually grew stronger. The program had 100 percent retention when it moved to a virtual platform, providing a valuable outlet for participants seeking extra support to maintain their health while quarantining.
After a year of success with the distance learning (online) program during the pandemic, UTMB Health became the first academic health center in Texas to achieve Full Plus Recognition. This recognition is valid through 2026.
PreventT2® is an evidence-based program that was developed by the CDC. It aims to help participants lose 5 to 7 percent of their body weight, which can decrease the risk of type 2 diabetes by 58 percent in individuals up to 60 years old. For those over 60, the risk is reduced by 71 percent.
The program spans one year, with sessions taking place weekly or biweekly during the first six months, then monthly thereafter. Sessions focus on fundamental skills, like eating healthfully and being physically active, dealing with environmental elements that can deter goal achievement, and the psychological and emotional issues that may hinder long-term change.
Each group typically consists of 10 to 15 participants. Several meeting times are offered to accommodate a wide variety of scheduling needs, and the program is offered in both English and Spanish. Dr. Serag says the PreventT2® team is hoping to expand its offerings to include programs in Mandarin and Arabic in the near future.
Individuals can self-refer to the program from its website, but the engagement of UTMB Health physicians has also been valuable in identifying individuals who may benefit. Dr. Serag says the program has equipped select UTMB Health clinics with tablets so that patients can take a self-assessment for diabetes risk while they wait to be seen.
“We ask the providers to screen everybody, and this does not add any burden on the providers because it’s a self-administered. Patients can fill it out to determine if they are eligible or at risk,” Dr. Serag said.
Participating locations include Community-Based Clinics, particularly in League City, Women’s Healthcare clinics in Angleton and Victory Lakes, and Stark Diabetes clinics in Galveston, Victory Lakes, and Angleton.
PreventT2® has been supported by a grant from the Texas Department of State Health Services, but the program is looking for long-term sustainability, so building capacity for reimbursement will be critical.
A major advantage is that the program is reimbursable by Medicare, Medicaid, and most commercial insurances. Although Blue Cross Blue Shield of Texas (BCBSTX), the insurance used by most UTMB Health employees, does not cover diabetes prevention programs in Texas, the PreventT2® team recently launched a pilot program with BCBSTX to cover UTMB Health employees and patients who participate. They are hopeful that, if the program demonstrates success, BCBSTX will expand coverage.
In total, about 100 individuals have gone through the program. Dr. Sallam says that once the year-long program ends, the benefits continue. The program has found that some group members stay in touch for support and continue to meet each other to go on walks and go shopping.
“They make this camaraderie and friendship within the group. This is what makes the program successful. It’s their communication with each other and with the coach,” Dr. Sallam says.
Health care providers whose patients may benefit from the PreventT2® program can find more information, including the risk assessment form, here.