Community: The Key to Preventing Diabetes at Scale

Breakthrough advancements in gene editing, personalized fitness tracking, and AI are the kind of technological marvels that fuel great optimism for the future of health. But, even as we digitize our world with wonderous gadgets and hyperconnected services, burdensome chronic diseases such as diabetes continue to spread unchecked. 84 million— or almost one in three people in the United States—has been diagnosed with prediabetes and is on a dangerous path toward developing type 2 diabetes and heart disease. That percentage is both staggering and sobering.

So, if technology has advanced so much, why are we in this predicament? Well, it turns out that human behavioral patterns account for the greatest impact on early death in the United States. People making poor health decisions in isolation is an enormous and growing problem. The scientifically proven solution to chronic disease lies not in checking our apps, but in establishing meaningful connection with others.

As illustrated in Michael Pollan’s popular Netflix series Cooked, technological advancement sometimes generates counterproductive impacts on human health. After World War II, the US began using innovations created to feed the troops (industrialized mass production, processed foods with long shelf-lives, frozen dinners, etc.) to feed American families. Within a couple of generations, technologies to improve food availability, convenience, and flavor-enhancement shifted our consumption habits drastically — and not necessarily to our benefit.

As a population, the US became larger, more sedentary, and less healthy. Did you know that simply commuting past fast food restaurants on your way to work increases the statistical probability that you’ll have a higher body-mass index (BMI) than your peers? It’s evident that the choices available in in your community matter.

Diabetes prevention is a distinctly human issue that requires a distinctly human approach. And the most powerful catalyst for change is found in our local communities. Software can help eliminate unhealthy habits, but it turns out that people need community support to sustain their new habits over time. To reverse the tide and curb the incidence of expensive chronic diseases like type 2 diabetes, we must find ways to take proven programs like the Diabetes Prevention Program (DPP)— originally developed by the CDC—and scale them nationally.

DPP

Since 2010, DPP has helped 200,000 people delay or avoid developing type 2 diabetes by providing intensive individual counseling and motivational support on effective diet, exercise, and behavior modification. As a result, DPP reduced program participants’ risk of developing diabetes by an impressive 58 percent. For every 10 people with prediabetes who completed the DPP program, the majority either slowed or halted their progression toward type 2 diabetes. Unfortunately, the number of DPP program participants to date constitutes a mere drop in the prediabetes bucket.

By scaling DPP across the US, we can move the health of our nation in a positive direction because we know that interpersonal, evidence-based lifestyle change programs reduce risk of type 2 diabetes and improve overall health. Technology is absolutely part of the equation, but human connection and effective face-to-face community care and support are the critical factors. In effecting lasting lifestyle changes.

Doctors, too, play an important role in reversing chronic disease, first by diagnosing the condition and then by recommending programs where they can monitor progress. Modern technology can help them do both with greater precision and efficiency, but the physician-patient relationship is central to long-term nationwide success. DPP shows that when the medical community can call on supportive coaches who provide day-to-day human interaction and a sense of a community, sustained behavior modification is possible in the majority of cases.

Bottom line: people have the greatest impact on other people. Embracing this truth has proven efficacy in preventing diabetes and associated chronic diseases. We’re building First Mile Care with these findings in mind. Technology definitely informs our approach and processes, but we know that when it comes to human health, community is essential to effecting lasting lifestyle changes.