Empowering Free Clinics to Address Prediabetes

An estimated 79 million American adults over the age of 20 has prediabetes. Only 11 percent of people with prediabetes are aware of it. According to a CDC study people with prediabetes account for 90 to 95 percent of new cases of type 2 diabetes, which presents a tremendous public health issue and opportunity. Because the vast majority of persons with prediabetes are unaware of their condition, identification and improved awareness of prediabetes are critical first steps. The lower the income levels the higher the rates of diabetes; rates are also highest among African Americans and Hispanics. There is little difference between rates of prediabetes but minority populations with diabetes are more likely to have higher rates of adverse health outcomes. Prediabetes is a treatable condition. The CDC’s National Diabetes Prevention Program (DPP) is a 12-month lifestyle intervention program proven to eliminate or delay the onset of diabetes. 

This AMA identified 8 physician-led free clinics across the country to implement a prediabetes education and screening protocol to identify and treat those at the greatest risk. The AMA Free Clinic initiative focuses on establishing onsite lifestyle coaches to offer the DPP onsite and integrate it with ongoing medical care. A study conducted by Bettina Tahsin et al found that the adoption of a combined lifestyle counseling/provider-patient reinforcement intervention showed significant reduction uncontrolled risk factors and improved outcomes. This session will explore the ability for a community-based clinic to address disparities in diabetes by adopting a prevention framework and focusing on prediabetes.