An adaptation of the diabetes prevention program for use with high-risk, minority patients with type 2 diabetes

PURPOSE The purpose of this pilot study was to determine the effectiveness of an edited Diabetes Prevention Program (DPP) Lifestyle Resources Core Teaching Plan for managing patients with type 2 diabetes in an urban underserved setting. Modifications were made to attempt to cut to the bare essentials to work within the constrained budgets of safety net providers. The primary aim was to achieve a mean absolute reduction in HbA1c level of 1 percentage point. METHODS The authors conducted a randomized controlled trial of 9 months' duration for patients with type 2 diabetes with an HbA1c >= 8.0%. A total of 67 patients randomized into usual-care and case management groups were evaluated with an intention-to-treat analysis. A modified DPP workbook was used during 7 monthly visits with a nurse case manager. RESULTS As compared with the usual-care group, those in the case management group experienced a greater reduction in HbA1c level (-1.87 vs -0.54; P =.011) and weight (-2.47 kg vs +0.88 kg; P =.011). CONCLUSION Use of an edited version of the DPP workbook in an urban, low-income, minority population with type 2 diabetes produced a significant absolute reduction in HbA1c percentage and weight.