Outcomes and Economic Benefits of Penn State Extension's Dining With Diabetes Program

Debra Griffie, Lynn James, Stephan Goetz, Brandon Balotti, Yau-Huo Shr, Marilyn Corbin, Timothy W Kelsey, Debra Griffie, Lynn James, Stephan Goetz, Brandon Balotti, Yau-Huo Shr, Marilyn Corbin, Timothy W Kelsey

Abstract

Introduction: Many diabetes education programs address the problem of diabetes, but little attention is given to the economic impact of such programs. Our objective was to assess the effectiveness of a community-based education program in improving diabetes-related lifestyle behaviors and biomarkers and ascertain the economic benefits of the program for adults aged 18 years or older with type 2 diabetes, prediabetes, or no diagnosis of diabetes in Pennsylvania.

Methods: From October 2012 through June 2015, Pennsylvania State University Extension's Dining with Diabetes program collected data on 2,738 adults with type 2 diabetes or prediabetes and adult family members without diabetes. The program consisted of 4 weekly 2-hour classes and a follow-up class conducted 3 months after the fourth 2-hour class. In the initial class and the follow-up class, participants completed a lifestyle questionnaire and their hemoglobin A1c and blood pressure were measured. Economic benefit was calculated as the medical expenditure cost savings resulting from program participation.

Results: At 3-month follow-up, a significant number of participants had improved their lifestyle behaviors (diet and physical activity), had reductions in hemoglobin A1c and blood pressure, and improved their diabetes status. The Dining with Diabetes program had a 5-year benefit-cost ratio of 2.49 to 3.35.

Conclusion: Participants who completed the Dining with Diabetes program had significant improvements in diabetes-related biomarkers and lifestyle behaviors. If the Dining with Diabetes program were extended to half of the 1.3 million people living with diabetes in Pennsylvania and if they had similar improvements, the 1-year benefit to the state would be approximately $195 million, assuming a conservative 15% decrease in direct medical costs.

Figures

Figure 1
Figure 1
Follow-up HbA1c compared with baseline HbA1c for participants with uncontrolled diabetes at baseline, Pennsylvania State University Extension’s Dining With Diabetes Program, October 2012–June 2015. Each point represents a study participant. Points below the diagonal line indicate a participant with a decrease in HbA1c, whereas points above the line indicate a participant with an increase in HbA1c. A point in the shaded areas indicates that a decrease was large enough to move the participant into a new, lower category of diabetes. The following categories of diabetes status were used: no diabetes (HbA1c <5.7), prediabetes (HbA1c 5.7–6.4), controlled diabetes (HbA1c 6.5–7.0), and uncontrolled diabetes (HbA1c >7.0).
Figure 2
Figure 2
Number of participants in each diabetes category, determined by HbA1c measurements, at baseline and follow-up, Pennsylvania State University Extension’s Dining With Diabetes Program, October 2012–June 2015. The following categories of diabetes status were used: no diabetes (HbA1c <5.7), prediabetes (HbA1c 5.7–6.4), controlled diabetes (HbA1c 6.5–7.0), and uncontrolled diabetes (HbA1c >7.0). [Table: see text]

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Source: PubMed

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