Preventing prediabetes

According to the Centers for Disease Control and Prevention, some 38.4 million people in the United States suffer from diabetes, with 90 to 95 percent of them having lifestyle-related Type 2. Disturbingly, 8.7 million of these individuals are unaware they have the chronic condition. Meanwhile, a whopping 97 million additional Americans have been diagnosed with prediabetes, putting them at heightened risk of eventually being diagnosed with the life-altering and incurable disease.

Complicating the fight against diabetes is the fact that the illness disproportionately affects low-income, working Americans who, in many cases, have limited access to adequate healthcare. This challenge is what motivated an innovative new effort to curb diabetes by Joyce Lee, a UC Irvine clinical professor of health sciences and a founding faculty member in the Department of Clinical Pharmacy Practice.

Earlier this year, she launched a pilot project in collaboration with Albertsons supermarkets to improve health outcomes for individuals living with prediabetes by integrating healthcare into their everyday routines. Albertsons pharmacists provide nutrition advice and other services while select UCI Health patients shop at their local supermarket.

The project’s goal is to eradicate prediabetic status, thus greatly reducing the number of people eventually diagnosed with diabetes. “If you have prediabetes, you don’t typically have any symptoms, and people may not take their nutrition that seriously, especially if they are active and busy and not feeling sick or exhausted,” Lee says. “A lot of times, they just carry on with their lifestyle until it’s too late. Maybe there’s a better way to meet their needs without having them losing half a day in the clinic just to be told that they need to be healthier.”

Through her pilot program, patients with prediabetes are invited to meet with health coaches, who are Albertsons pharmacists, during their grocery shopping trips. These coaches offer personalized advice on healthy food choices and lifestyle modifications directly in the supermarket aisles. “The aim is to introduce small, sustainable changes in people’s lives, thereby helping them achieve significant health improvements,” Lee says. “Pharmacists are trained frontline healthcare professionals who can empower people beyond just medications.”

Launched in March after receiving a UC End Disparities grant in November 2023, the study has already shown promising results. “At three months, six patients had already completed the program and reverted back to normalcy,” Lee says.

The project is comprehensive, combining face-to-face interactions with digital support. Participants receive follow-up phone calls and educational content aimed at reinforcing healthy eating habits and an active lifestyle. At each stage, their progress is monitored, they’re referred to a certified dietitian if needed, and their health data is communicated back to their primary care providers, thus ensuring a cohesive care experience. Patient success is enhanced by allowing each to choose a conveniently located store from Albertsons’ 35 sites in Orange County. This is particularly beneficial for underserved patients who may have transportation challenges.

If the study continues to prove to be successful, Lee says, it could pave the way for insurance companies to offer more resources and support for people with prediabetes, fostering broader policy and healthcare shifts.

“One person with diabetes – the cost to the government and to themselves is enormous,” she says, noting that in 2022 people with diabetes incurred average annual medical expenditures of $19,736, of which about $12,000 was directly attributable to diabetes. “People diagnosed with diabetes generally have medical expenditures 2.6 times higher than what would be expected without diabetes,” Lee says. “We can’t cure people with diabetes, but if we can turn this around and invest more in people with prediabetes, I think we would have a practical solution to stop diabetes.”

If you want to learn more about supporting this or other activities at UC Irvine, please visit the Brilliant Future website. By engaging 75,000 alumni and garnering $2 billion in philanthropic investment, UC Irvine seeks to reach new heights of excellence in student success, health and wellness, research and more. The School of Pharmacy & Pharmaceutical Sciences plays a vital role in the success of the campaign. Learn more by visiting https://brilliantfuture.uci.edu/school-of-pharmacy-and-pharmaceutical-sciences.