Case Reports on Adults >80 Years of Age in the National Diabetes Prevention Program.

Abstract

More than half of U.S. seniors are estimated to have prediabetes (1), creating a high level of need for effective interventions that prevent progression to type 2 diabetes. Evidence shows that lifestyle interventions for weight loss are especially effective among older adults, suggesting great potential to reduce disease burden in this priority population. In the landmark Diabetes Prevention Program (DPP) clinical trial, participants ≥60 years of age who received lifestyle intervention had a 71% initial reduction in diabetes incidence, exceeding the 48% average reduction for those 25–44 years of age and the 59% average reduction for those 45–59 years of age (2). Seniors have continued to achieve the most weight loss in the National Diabetes Prevention Program (NDPP), a widely disseminated translation of the DPP’s lifestyle arm intervention (3). Yet, limited prior study of seniors >80 years of age leaves a knowledge gap for whether to recommend the NDPP and similar programs for these older adults. Specifically, an American Geriatrics Society consensus report posits that seniors close to the age of 65 years with diabetes risks should generally receive lifestyle intervention, whereas 95-year-olds should not (4), without providing guidelines for seniors between those ages. Even prior research focused on delivering the NDPP to older adults has included participants predominately around the age of 63 years without reporting outcomes specific to older seniors (5). To explore whether the NDPP may benefit seniors in their 80s and understand special considerations that may be necessary for this population, we examined case studies of NDPP participants >80 years of age. We delivered the year-long NDPP intervention in a Denver, CO, health care system to adults meeting eligibility criteria established by the Centers for Disease Control and Prevention (CDC), including BMI ≥24 kg/m2 (≥22 kg/m2 if Asian) and prediabetes, history of gestational diabetes, …