Thought Leadership in Action

In the 21st century, people are increasingly familiar and comfortable with online communities and communicating via the internet. Now there is evidence a chronic health condition - type 2 diabetes - may be prevented with help from digital health platforms using virtual coaching and monitoring.

According to the Centers for Disease Control and Prevention (CDC), diabetes in the US has reached epidemic proportions. Over 29 million Americans have the disease and the majority has type 2 diabetes. Previously called adult-onset diabetes, this form is associated with being overweight and sedentary and health experts say the condition can often be avoided with lifestyle changes.

Successfully preventing many cases of type 2 diabetes would have enormous consequences, both for individuals and for the economy. The American Diabetes Association reports that the total estimated cost of diagnosed diabetes is $245 billion, including $176 billion in direct medical costs and $69 billion in reduced productivity.

The CDC is making type 2 diabetes prevention a high priority and promoting the National Diabetes Prevention Program (DPP). The aim is to identify people who have pre-diabetes and help them avoid becoming diabetic by adopting changes in their diets and activity levels. Pre-diabetes is characterized by a blood glucose level higher than normal and typically develops in people who are overweight.

The DPP incorporates the use of science-backed programs to reduce the diabetes risk factors associated with pre-diabetes. One goal of the program, for example, is to help the obese and overweight lose 5% - 7% of their weight. CDC approved DPP strategies include counseling on healthy diets and weight control and A1C monitoring. A1C blood tests provide information about a person's average levels of blood glucose over the past 3 months.

Currently, approximately 527 organizations are offering the CDC-approved DPP interventions. As part of this nation-wide initiative to prevent type 2 diabetes, for the first time the CDC is including digital health programs that track weight, waistlines and A1C test results and act as virtual coaches to help people with pre-diabetes make lifestyle changes that reduce diabetes risk. San-Francisco based Omada, Noom Health of New York, and Los Angeles-based DPS Health are the first companies with digitally-centered programs that meet the standards of the CDC’s DPP.

But can a virtual diabetes prevention program actually help people with pre-diabetes improve their health and lower their risk of developing diabetes? A recent study by University of California researchers documented that the answer is “yes.” The research, published in The Diabetes Educator journal, evaluated Omada’s online social network-based program called Prevent, which follows the lifestyle guidelines of the CDC’s DPP. The plan enrolls pre-diabetics in virtual communities where they receive nutrition and exercise advice and have 24 hour a day access to a nutrition and fitness couch. Omada provides each participant with a pedometer to record physical activity and scales equipped with chips that record and email the results when Prevent members weigh themselves.

Two hundred twenty people diagnosed with pre-diabetes were recruited online and enrolled in Prevent for the University of California-led study. In all, the participants went through 16 weeks of lifestyle interventions using the virtual program and several months of maintenance intervention, for a total of 12 months. At the end of that time, 187 research volunteers had lost around 5% of their weight and their A1C tests substantially improved, showing the risk for type 2 diabetes was reduced.

“Considering national initiatives to address the obesity and diabetes epidemics, online delivery platforms like Prevent offer an effective and scalable solution,” the study authors concluded. The CDC’s website provides a national registry of type 2 diabetes prevention programs, including virtual programs that comply with the DPP standards.