Modeling the Impact of Combined Individual and Population-level National strategies for preventing type 2 diabetes.

Abstract

Preventive strategies for type 2 diabetes (T2D) include interventions aimed at modifying population-level risk factors and interventions targeting individuals at elevated risk. However, the combined national impact of these approaches has not been quantified. This study used a simulation model to estimate the number of incident T2D cases and diabetes-related complications that could be prevented over 10 years by implementing evidence-based, combined preventive strategies. These included population-level sugar-sweetened beverage (SSB) reduction interventions and individual lifestyle intervention programs for adults with elevated glycemic risk (HbA1c 5.7%-6.5%). Two scenarios were evaluated: (a) a moderate strategy involving a 13% reduction in SSB consumption and an online lifestyle intervention; and (b) an intensive strategy involving a 55% reduction in SSB consumption and an in-person lifestyle intervention. A nationally representative cohort of U.S. adults without diagnosed diabetes was constructed using data from the 2013-2018 National Health and Nutrition Examination Survey. The moderate strategy was projected to prevent 3.7% (562,546) of new T2D cases over 10 years, while the intensive strategy would prevent 12.8% (1,958,164). The number of diabetes-related complications prevented was generally aligned with the reduction in incident T2D cases. Across different scenarios, of the total cases prevented, 64%∼98% were attributable to the SSB reduction. These findings demonstrate the potential national impact of integrating population-level strategies to reduce SSB consumption and a targeted Diabetes Prevention Program intervention to reduce the incidence of T2D and its complications.