In 2012, few people thought diabetes prevention would be synonymous with AADE. The 2012 National Practice Survey showed that almost 80 percent of diabetes educators reported providing some sort of prevention programming, but almost zero percent were reimbursed for it. At this time, most educators were unaware of the National Diabetes Prevention Program (National DPP) or the role of a diabetes educator/DSMES program in this space. There was also, understandably, frustration around the lack of structure to and reimbursement for these much-needed preventative services.

AADE also signed a cooperative agreement with the CDC in 2012, which allowed us to help create that structure. AADE took a few months of planning before deciding on the “AADE DPP model” to implement the CDC-led, evidence-based National DPP within existing accredited or recognized DSMES programs. We knew that providing a structured prevention program within a DSMES program would provide a good base for the National DPP, and we hypothesized it would also add value and strength to the DSMES program as well. 

One by one, AADE started to work with DSMES programs to test out this concept, watching the benefits and barriers of this model unfold. We focused on gathering feedback from diabetes educators on their perception of being able to facilitate diabetes prevention versus delivering diabetes education, as well as how playing a part in the National DPP felt like a well-suited role for a diabetes educator. Finally, we began to see and hear how it changed the lives of participants, and how delivery of our program model was successful, often with higher rates of weight loss and completion than other programs.

During that time, AADE has seen what works and what doesn’t. Here are some of those take-aways.

DSMES programs provide an ideal setting to add the National DPP because:

• They have a pool of eligible participants through emergency rooms
• They are HIPAA compliant and accustomed to proper data collection and entry
• The program staff includes diabetes educators (HCPs) who offer higher level guidance and support and are trained to work with other health issues
• They are already billing and have an NPI number, so are well-suited to become MDPP suppliers and bill private payers
• They are already providing service for payers and can bundle prevention with DSMES and screenings, increasing sustainability for all services
• Linkages exist with local primary care providers to increase DPP and DSMES referrals
• Some offer experience with telehealth delivery and other types of telemedicine 
• Most importantly, DSMES programs offer transition of care for people who end up being diagnosed with type 2 diabetes

Prevention continues move to the forefront of diabetes care, and AADE continues to create educational programming and tools that help people avoid or delay developing type 2 diabetes. This includes workshops, webinars, online learning opportunities and lifestyle coach trainings. It also includes the AADE Prevention Network and Data Analysis of Participants System (DAPS) database system. All these tools were designed to ensure DSMES programs and all those involved in diabetes prevention have what they need to broaden their spectrum to be able to serve both people with diabetes and those at high risk for developing type 2 diabetes in their community.