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As of 2016, diabetes affects more than 29 million people in the United States and is the 7th leading cause of death nationwide. In Vermont, 1/10 people are diagnosed with either diabetes or prediabetes, with 6% of Vermonters affected by prediabetes and 5% of Chittenden Country affected by prediabetes. The public health burden of this chronic disease is immense: diabetes costs Vermont an estimated $543 million each year and is the leading cause of kidney failure, lower limb amputations, and adult-onset blindness. Prediabetes occurs when blood sugar is higher than normal but not at the diagnostic threshold of diabetes. Prediabetes does not definitely progress to type 2 diabetes if interventions are made, including healthier eating and physical activity to promote modest weight loss. The CDC has developed evidence-based curricula for lifestyle intervention in prediabetics with intensive individual counseling and motivational support on effective diet, exercise, and behavior modification. One of these curricula is currently run through the CDC-led National YMCA Diabetes Prevention Program (YDPP). Participation in this program reduces the risk of developing type 2 diabetes by 58% across all ethnic groups and sexes overall and by 71% in individuals over age 60. The Vermont YDPP had 325 participants in 2016, with only 21% (n=70) of those referrals to the program coming from healthcare providers. Healthcare providers have a unique role in the community of being the voices of health promotion. With the correct provider awareness of the YDPP and patient identification, awareness, and education, an increase in the percentage of YDPP-referring healthcare providers can increase the overall YDPP participation in Chittenden county. As of 2016, 60,038 people in Chittenden county have prediabetes, but only 8,026 are diagnosed, and an additional 52,012 people could be diagnosed with prediabetes by their healthcare professional and referred to the YDPP. This campaign intends to serve as a pilot project to create provider and patient awareness of the YDPP, identify patients with prediabetes, and ensure providers screen and refer prediabetic patients to the YDPP. Through exam room posters, panel query management, electronic medical record reprogramming, and targeted patient intervention, this study aims to increase YDPP patient participation via healthcare provider referral and refine the model for adaptation and implementation in other healthcare centers throughout Chittenden County.

Clinical Site

Thomas Chittenden Health Center


diabetes, prediabetes, public health, lifestyle, preventive medicine, quality improvement

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Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.


Community Health and Preventive Medicine | Endocrine System Diseases | Endocrinology, Diabetes, and Metabolism | Family Medicine | Medical Education | Medical Nutrition | Nutritional and Metabolic Diseases | Preventive Medicine | Primary Care

Combating Diabetes in Chittenden County: A Healthcare Provider Referral Campaign to Increase Patient Participation in the Vermont Diabetes Prevention Program