Food As Medicine: Why Lifestyle Change Programs Are A Key Part of Diabetes Prevention

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Food As Medicine: Why Lifestyle Change Programs Are A Key Part of Diabetes Prevention

Monday, July 24, 2017

When we talk about lifestyle change, we talk about food as almost the underlying part of all of it because we know that diabetes occurs more frequently in overweight individuals, and there are other components of diet that if modified may help delay or better control diabetes," said Michigan State Medical Society (MSMS) President Cheryl Gibson Fountain, MD.

However, time doesn't allow for you to work with individual patients to improve their diet. But what if food was prescribed, similar to medicine, as part of a diabetes management approach?

Geisinger Health System in Central Pennsylvania tried this approach when it launched the Fresh Food Pharmacy program for its patients with type 2 diabetes to help them manage or reverse the disease.

Patients meet with a registered dietitian who gives them healthy recipes and meal prep instructions for the week. They then shop at the pharmacy for free groceries made up of fresh produce, lean proteins and healthier carbohydrates, all of which adhere to the US Dietary Guidelines for 2015-2020.

The program also includes wellness classes, healthy eating workshops and support from physicians, case managers and pharmacists.

Lifestyle Change Programs Get Results

Results so far have been encouraging. Physicians are seeing drops in hemoglobin A1C (HbA1C) levels and weight along with lower blood pressure resulting in reduced medications and fewer complications arising from type 2 diabetes.

Geisinger reported that it would spend $1,000 per patient in one year's time for 180 participants -- a drop in the bucket when U.S. costs related to diabetes are estimated at more than $240 billion each year, according to the Centers for Disease Control and Prevention (CDC). Savings for a 1-point HbA1C decrease was an estimated $8,000. Many patients saw a 3-point reduction in HbA1C, which was approximately a $24,000 health care cost savings.

These results demonstrate how effective lifestyle change can be for people with diabetes. The same is true when it comes to preventing diabetes. Lifestyle change programs that are part of the National Diabetes Prevention Program have demonstrated similar success. According to the CDC, participation in lifestyle change programs among adults with prediabetes lowered their incidence by 58%, and for those 60 years and older, it was reduced by 71%.

You can help your patients achieve these results by using toolkits such as Prevent Diabetes STAT: Screen, Test, Act -- Today to screen patients and then refer them to a lifestyle change program.

Interventions Provide Opportunities And Extended Reach

Programs like these also provide another opportunity to educate your patients and connect your health care organization with your community.

"Many times physicians see individuals who have never cooked for themselves, don't know very much about food and don't really have the skills needed to put a really basic, simple, healthy meal on the table," explained Doctor Gibson Fountain.

"So that education component with the dietitian is pretty important," added Doctor Gibson Fountain. "The Food Pharmacy program goes from telling the patient what to do to actually showing them by practicing shopping and actually working with a dietitian to learn healthy ways to prepare the food and how to incorporate them into the diet."

Having the education component with the dietitian also establishes a relationship with the health care organization, the program and the physician. If the patient is comfortable coming back, problems can be caught early, before they develop into complications.

"It helps establish more contact with the health care system, and there's also someone there monitoring them or looking out for them in addition to their physician who they may only need to see every six months or so," said Doctor Gibson Fountain.

Programs like these also encourage community partnership as well. For example, several supermarket chains have dietitians on-site to conduct tours to help people learn what to shop for. Physicians can in turn work with local supermarkets to refer patients out for help with the shopping and food planning process.

An important benefit of lifestyle change programs like the National DPP is that they can get family members involved, which goes one step further in diabetes prevention. Risk factors for diabetes often run in families so patients have the opportunity to positively influence other people in the household.

"If you can extend that benefit, you do two things. One is you make meals healthier for other individuals, but you also increase the support system for the patient. And it's pretty important for the individual trying to manage the medical condition to have someone else in the household engaged in it," said Doctor Gibson Fountain.

Although lifestyle changes may feel dramatic for your patients and their families, even simple changes can have a big impact.

"The nice thing about food and nutrients that we've learned over the last 10 years is that even small changes can make a pretty good-size difference. If patients just cut out that afternoon soda, for example, it can make a difference in their blood work when they go see their doctor," said Doctor Gibson Fountain.

AMA Resources for Lifestyle Change Programs