1 Apr, 13 | by Dr Dean Jenkins
We know from a number of studies – including the Diabetes Prevention Programme (DPP)  and the Finnish Diabetes Prevention Study  – that lifestyle advice to people with abnormal glucose metabolism greatly reduces the risk of diabetes. However, the interventions are expensive.
Researchers from the Wake Forest University School of Medicine in the US have therefore looked at the use of community-based programmes to achieve the same results. They report the two year results  of their Healthy Living Partnership to Prevent Diabetes (HELP-PD) programme that uses community health workers leading groups in parks and recreation centres rather than clinics. They claim their results are comparable with those at a similar stage in the DPP but at a third of the cost.
This is a well documented randomised controlled trial that demonstrates efficacy and cost-effectiveness but only in one county in the US. Local policies and culture (strong pre-existing community networks and motivation) could have affected the results. Community prevention strategies if they can be deployed successfully could feasibly be more cost-effective than more traditional, clinic-focussed services.
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