Weight loss and modeled cost savings in a digital diabetes prevention program

Abstract

Background: Participation in the National Diabetes Prevention Program (DPP) can improve individual health through reduced risk of type 2 diabetes and save the healthcare system substantial medical costs associated with a diagnosis of type 2 diabetes and its associated complications. There is less evidence of outcomes and cost savings associated with a fully digital delivery of the DPP. Methods: This study assessed 13,593 members who provided an initial digital weight and subsequently achieved various weight loss and engagement outcomes during their participation in a digital DPP. Analyzed data included both complete observations and missing observations imputed using maximum likelihood estimation. Findings include members' behavioral correlates of weight loss and a literature-based cost-savings estimate associated with achieving three mutually exclusive weight loss or engagement benchmarks: ≥5% weight loss, >2% but <5% weight loss, and completion of ≥4 educational lessons. Results: 11,976 members (88%) provided a weight after 2 months of participation, enabling calculation of their weight nadir. Considering complete data, 97% of members maintained or lost weight. Using the imputed data for these calculations, 32.0% of members achieved ≥5%, 32.4% achieved >2% but <5%, 32.0% maintained �2%, and 3.6% gained weight. Members who lost the most weight achieved their weight nadir furthest into the program (mean day = 189, SE = 1.4) and had the longest active engagement (mean days = 268, SE = 1.4), particularly compared to members who gained weight (mean nadir day = 119, SE = 3.7; active engagement mean days = 199, SE = 4.9) (both p ≤ 0.0001). Modeled 1-year cost-savings estimates ranged from $11,229,160 to $12,960,875. Conclusions: Members of a fully digital DPP achieved clinical and engagement outcomes during their participation in the program that confer important health benefits and cost savings.

Enrollment, Engagement, and Effectiveness of a Large-Scale Diabetes Prevention Program Using Synchronous Distance Technology

“…A previous study looking at cumulative enrollment in the NDPP by delivery mode between January 2012 and December 2019 showed that online and distance learning participants were overwhelmingly enrolled in programs run by organizations classified as for-profit businesses or insurers [26]. Additionally, the findings highlight the importance of program completion on weight loss and A1C reduction, aligning with previous research emphasizing the importance of longer program engagement for weight loss and diabetes prevention [27][28][29][30].…”

“…Program completers lost on average 12.56 pounds or 5.66% of their body weight during the program. Previous papers have highlighted that longer engagement in a DPP is associated with larger weight loss [27][28][29][30]. Participants of the ESMMPD program reached the weight loss goal set by the NDPP lifestyle change program which states that if individuals with pre-diabetes achieve a moderate 5-7% weight loss (along with 150 weekly minutes of physical activity), they can prevent the onset of type 2 diabetes by 58%.…”

Enrollment, engagement, and effectiveness of a large-scale diabetes prevention program using synchronous distance technology

“…Program completers lost on average 12.56 pounds or 5.66% of their body weight during the program. Previous papers have highlighted that longer engagement in a DPP is associated with larger weight loss [23,25,26]. Participants of the ESMMPD program reached the weight loss goal set by the NDPP lifestyle change program which states that if individuals with pre-diabetes achieve a moderate 5%-7% weight loss (along with 150 weekly minutes of physical activity), they can prevent the onset of type 2 diabetes by 58%.…”