Progression to Diabetes by Adults With Prediabetes Who Use the National Diabetes Prevention Program: A Natural Experiment
Authors' conclusion
For privately insured adults with prediabetes, using NDPP was associated with lower progression to diabetes over 1-2 years.
Study context
- Population
- Privately insured adults with diagnosed prediabetes (claims 2015–2019) and at least one procedure code for lifestyle treatment, 5,714 health plans across all 50 US statesof 3.73 million with prediabetes
- Participants
- 245,896 participants
- Exposure
- National Diabetes Prevention Program (NDPP) vs lower-intensity lifestyle services
- NDPP treatedn = 27,703
- Outcome
- Progression to diabetes (cases of diabetes per 100 adults)
- Follow-up
- 12 and 24 months
Methodological detailsnatural experiment, instrumental variable estimation, claims-based
- Natural experiment
- Instrumental variable estimation
- Claims-based
Main finding
As reported in the abstract
Fewer cases of diabetes per 100 adults in NDPP vs lower-intensity services (instrumental variable (IV) estimation)
Fewer cases of diabetes per 100 adults at 12 months
1.94
95% CI 1.44–2.44
NDPP treated
Fewer cases of diabetes per 100 adults at 24 months
1.58
95% CI 0.76–2.39
NDPP treated
Observational data: associations, not effects.
Further findings
Characteristics of NDPP-treated patients
- NDPP-treated patients were more often women, aged <55 years, and less likely to live in low-poverty zip codes
Original publication
Progression to Diabetes by Adults With Prediabetes Who Use the National Diabetes Prevention Program: A Natural Experiment. Diabetes Care. Published 2 June 2026. doi:10.
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