Health care organizations play a critical role in diabetes prevention by identifying and managing individuals with prediabetes. This project piloted a systematic diabetes prevention evaluation ’M.A.P. model’. The framework’s key components includes the ’M’ related to ’measuring accurately’ by identifying adults with prediabetes; the ’A’ related to ’acting rapidly’ by initiating treatment specifically, referral to a National Diabetes Prevention Program (DPP) lifestyle change program (LCP); and the ’P’ related to ’partnering with patients’ to support treatment participation in a LCP. The model was implemented at 3 grantee sites focused on building capacity to address diabetes prevention in a target disparate population of women who identify as Black and/or Hispanic. Aggregate data for a 12-month baseline period for the ’M’ metric found that the total number of adults at risk for abnormal glucose with laboratory tests ordered averaged only 57% (39-69%) of those eligible and 61% (39-69%) for those sites participating in the intervention. Documentation of a prediabetes diagnosis with an ICD-10 code was 51% (42-65%) for the total and 58% (42-65%) among the participating sites. The ’A’ metric submitted by 2 sites to date found only 8% (7-9%) of all patients and 10% (9-42%) of target population patients eligible for the LCP had a clinical referral order. Data for the ’P’ metric submitted by 1 site to date reported a 25% enrollment rate, of which 86% consisted of the target population, and 91% were referred from a primary care provider rather than a self-referral. The findings highlight that tracking metrics related to diabetes prevention in health care organizations is feasible. The initial results suggest that a structured evaluation model can help organizations and clinical care teams identify opportunities for improvement and guide targeted activities to increase prediabetes patient identification, National DPP LCP referrals, and program enrollment and completion rates.


T. Khan: None. A. Hughes: None. N. Sachdev: None. A. Balan: None. D. Pere: None.


Centers for Disease Control and Prevention (6NU38OT000289-01-01)

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