In 2010, Congress authorized the creation of the National Diabetes Prevention Program to build a nationwide delivery system for a lifestyle change program (LCP) proven to prevent or delay the onset of type 2 diabetes. In 2012, the Diabetes Prevention Recognition Program (DPRP) approved its first CDC-recognized organization. Over the last years, CDC has recognized ∼4000 organizations to deliver the LCP to 500,000+ participants. This analysis looks at the impact of changes to the DPRP national quality standards on participant outcomes. The initial version of the DPRP Standards covered the period 1/1/12-12/31/14. Later versions were released on 1/1/15, 3/1/18, and 5/1/21. Data for participants who entered the LCP during each version were analyzed with respect to enrollment, starting body mass index (BMI) , and % weight change. Enrollment during version 1 climbed to 24,614 based on in-person delivery. Version 2 introduced virtual delivery and enrollment reached 227,329. Version 3 reflected changes to accommodate the Medicare Diabetes Prevention Program. In-person enrollment increased 36% from 2018 to 2019, while online enrollment decreased over that period. Version 3 saw the public health emergency that caused most in-person enrollment to halt while organizations shifted to virtual platforms. In-person enrollment during 2020 ranged from a low of 763 in April to almost normal numbers of 2000+/month by September. Mean BMI was highest for those who started the LCP in 2012 (version 1) and 2021 (version 4) at 36.2 and 36, respectively. Those enrolled in organizations using combination (in-person + virtual) delivery had the highest mean BMI, regardless of version. Mean % weight loss for those who completed 9+ months of the LCP was highest during version 1 (6.3) . Version 3 produced the lowest at 5.2, which was also the mean % in 2020. The DPRP has endured program changes, as well as external factors. The evidence-based LCP continues to enroll participants looking to reduce their risk of developing type 2 diabetes.