Diabetes Prevention Programs
The Life! Taking Action on Diabetes Program is an evidence based lifestyle modification program which has the potential to substantially delay or prevent the development of type 2 diabetes. Clinical trials have provided strong evidence that progression to Type 2 Diabetes can be prevented or delayed by lifestyle modification. Randomised Control Trials in the US and Finland have demonstrated reductions in the incidence of Type 2 Diabetes of 58% over 3 years.
What is a Lifestyle Modification Program?
The Life! Taking Action on Diabetes Program has been accredited as a Lifestyle Modification Program. Patients aged 50 years and over who are identified as being at “high risk” of developing type 2 diabetes (using the AUSDRISK tool) and who do not already have diabetes, and 18 years and over and have a history of Gestational Diabetes Mellitus (GDM) or Ischemic Heart Disease (IHD), can be referred to the program.
What is included in a Lifestyle Modification Program?
- Setting small, achievable goals to improve one’s lifestyle
- Problem solving skills
- Type 2 diabetes and its complications
- What you should drink and eat to stay healthy
- How physical activity can help
- How to make healthier lifestyle choices
The program will help to maintain the lifestyle changes that can delay or prevent the onset of type 2 diabetes.
Each course runs for six sessions (90 minutes each session) with up to 15 participants. The first five sessions are fortnightly; the sixth session is a follow up and takes place eight months after the first session.
To be eligible for a Life! course patients must:
- Be aged 50 years or above or over 18 years and of Aboriginal or Torres Strait Islander descent
- Score 12 or more on the Australian Type 2 Diabetes Risk Assessment (AUSDRISK) Tool
- Have diabetes excluded in the past 12 months
- A standard Medicare Benefits Schedule(MBS) item number consultation applies for individuals 50 years of age and over
As of 1st July, 2010 the following changes apply to the entry criteria for Life!
- AUSDRISK score reduced from 15 to 12
- Simpler entry for adults with pre-existing ischemic heart disease
- Easier entry for women who have been diagnosed with gestational diabetes mellitus (GDM)
1. AUSDRISK score reduced from 15 to 12 This change has also been made by the Commonwealth Prevention of Type Diabetes Program
The Department of Health and Ageing recently reviewed the categorisation of high risk by the AUSDRISK tool, an AUSDRISK score of 12 or above is now considered at ‘high risk’ of developing diabetes in the next five years. See below for the new categorisation of risk according to AUSDRISK score:
Scores of 20 and above high risk; approximately 1:3 will develop diabetes,
Score of 16 to 19 high risk; approximately 1:7 will develop diabetes,
Score of 12 to 15 high risk; approximately 1:14 will develop diabetes,
Score of 8 to 11 intermediate risk; approximately 1:30 will develop diabetes,
Score of 6 to 8 intermediate risk; approximately 1:50 will develop diabetes,
Score of 5 or less low risk; approximately 1:100 will develop diabetes.
2. Simpler entry for adults with pre-existing ischemic heart disease
Cardiovascular disease, particularly ischemic heart disease (IHD) has been well established as an independent risk factor for type diabetes. Therefore, adults with history of IHD will now be eligible to take part in the Life! program regardless of their age* or AUSDRISK score. The definition of pre existing IHD suitable for entry into the Life! program will be any person with self reported history of the following heart conditions:
- Myocardial infarction/ heart attack
- Angina
- Angioplasty
The initial experience/diagnosis of one of these heart conditions should not occur within 3 months of commencing the program.
3. Easier entry for women who have been diagnosed with gestational diabetes mellitus (GDM)
Women who have had a previous diagnosis of GDM have a 50% lifetime risk of developing type 2 diabetes placing them at high risk. All adult women who have experienced GDM and are not currently pregnant can be referred to the Life! program regardless of their age* or AUSDRISK score. This criteria will be based on self report of the GDM diagnosis.
What is the inclusion criteria for referring to the Life! program?
In summary, to determine person’s eligibility to be referred to the Life! Taking Action on Diabetes program, the criteria is now as follows:
- Diabetes excluded; AND
- History of high risk condition, specifically pre existing condition of either CVD/GDM in adults aged over 18; OR
- AUSDRISK score of 12 or more and aged over 50 or over 18 if an Aboriginal or Torres Strait Islander.
Are there any exclusions for referring into the Life! program?
Yes. People with any of the following conditions are not eligible to enrol in the Life! Taking Action on Diabetes program:
- Diabetes
- Pregnancy
- Recent angina diagnosis/angioplasty/myocardial infarction within the last months
Case Finding funding for general practice – Life! 50+
Case finding funding is currently available for all Victorian general practitioner’s. Updated information on the sign up process for practices and resources to support case finding in practice are available on the diabetes Life! web site. Current case finding agreements expire on 30/06/2012.
Contact Details for Life! – Lifestyle Modification Program
Latrobe Community Health Service
Phone: 1800 242 696
Fax: 5136 5475
Email: info@lchs.com.au
Website: www.lchs.com.au
West Gippsland Healthcare Group
Phone: 5624 3500
Fax: 5624 3555
Email: info@wghg.com.au
Resources
You Can Help Prevent Type 2 Diabetes in Your Patients – GP Fact Sheet (PDF)
The Prevention and Diagnosis of Type 2 Diabetes Flowchart (PDF)
The Management of Type 2 Diabetes Flowchart (PDF)
Case Finding and Referral to the Life! program (PDF)
Templates
Downloading from this site:
Right click on link and select Save Target As…
Select a location on hard drive (which you can find later, such as the desktop) and save
Life! Referral Form – Medical Director (RTF)
Life! Referral Form – Best Practice (RTF)
