The original Diabetes Prevention Program (DPP) study, and the various studies that have replicated and aimed to translate it, has made it clear: prevention of type 2 diabetes, or at least the delay of its onset, is possible in people with prediabetes through lifestyle change. We repeatedly heard the refrains that the DPP showed prevention is “not rocket science” and “not magic.” We know exactly what it takes. A weight loss of as little as 5%-7% (although 10% or more may be ideal), in conjunction with 150 minutes per week of physical activity, can significantly reduce the progression of prediabetes to diabetes. The evidence is considered sufficiently conclusive that the Centers for Medicare & Medicaid Services (CMS) declared that DPP programs have a full return on investment within four years, and it announced it would start reimbursing for approved DPP involvement in 2018, the ultimate seal of approval.
