Mass General Brigham Health Plan and The Massachusetts General Hospital Diabetes Center offer the Path to Lifestyle Change program to help our members lose weight—and delay or prevent type 2 diabetes. The Path to Lifestyle Change was created and is being directed by Linda Delahanty, MS, RD, the Director of Nutrition and Behavioral Research at the Mass General Diabetes Center. In recognition of National Diabetes Awareness Month, continue reading to learn more about Linda’s passionate commitment to supporting anyone impacted by diabetes.
Who is eligible to enroll in Path to Lifestyle Change?
Path to Lifestyle Change is a two-year diabetes prevention program delivered remotely to patients with prediabetes—and at high risk of developing type 2 diabetes. It is a fully covered benefit for members at Mass General Brigham Health Plan who are eligible based on a hemoglobin A1c level in the prediabetes range or a high score on the diabetes risk test. Learn more about the program below.
How is the Path to Lifestyle Change impacting the life of members?
Path to Lifestyle Change is a 2-year clinical program designed to prevent or delay the development of diabetes in people at high risk of developing the disease—aimed at achieving a 7% weight loss and 150 minutes of activity per week. Participants learn about nutrition, physical activity, and behavioral strategies and receive the education, tools, and support that they need to make lasting lifestyle changes. They learn lifestyle skills for healthy eating, increased activity, and behavior change that have been proven to promote sustained weight loss and delay or prevent diabetes. The program has provided people an opportunity to focus on their self-care, weight management, and health during the COVID pandemic, a time when the average weight gain has been 29 pounds.
What is the ultimate goal of Path to Lifestyle Change?
The ultimate goal of the Path to Lifestyle Change program is to prevent type 2 diabetes in those at high risk to develop it through weight loss and increased activity. This 2-year program teaches people lifestyle strategies and skills for managing eating and activity habits in doable, liveable, and sustainable ways. The first six months focus on skills for losing weight, and the 18-month follow-up phase focuses on skills to keep the weight off once it is lost. Ultimately, we hope to prevent diabetes, improve blood pressure, cholesterol levels, overall health, and quality of life. We hope to reduce health care costs associated with diabetes and its treatment.
As a diabetes nutrition specialist, I know firsthand the importance of preventing diabetes. Upon diagnosis, diabetes involves a very demanding self-care regimen and is expensive to treat. If diabetes is poorly controlled, the risk for diabetes complications like heart attacks, strokes, and kidney failure is high, and so is the cost of care and treatment for many associated health problems.
How did you become the Director of Nutrition and Behavioral Research at The Massachusetts General Hospital Diabetes Center?
I have been working as both a diabetes nutrition specialist and a nutrition scientist for over 30 years. I was appointed as the Director of Nutrition and Behavioral Research in 2003 based on my experience as co-investigator or Principle Investigator on several NIH-funded clinical trials in nutrition and lifestyle interventions for prediabetes, diabetes, and obesity.
At this point, I have been a co-investigator or Principle Investigator on eight large NIH-funded trials focused on the impact of nutrition and lifestyle interventions on health outcomes such as prediabetes, diabetes, obesity, hyperlipidemia, metabolic syndrome, breast cancer, genetics, and quality-of-life. I’m one of the architects of the lifestyle interventions for each of these trials. Therefore, I have extensive experience in the design and effective delivery of nutrition and lifestyle interventions to maximize participant engagement and weight loss results.
What was your role in creating the Path to Lifestyle Change program?
I was a co-investigator on the original landmark Diabetes Prevention Program (DPP) and one of the architects of the lifestyle intervention, which turned out to be more powerful than a diabetes medication in preventing diabetes. The lifestyle intervention resulted in a 58% risk reduction, whereas the medication metformin resulted in a 31% risk reduction compared to no intervention. There was a real need to offer this type of program and its benefits as a clinical program so that other people have a chance to prevent diabetes and protect their health in the same way. After developing a proposal for a diabetes prevention program out of the Mass General Diabetes Center, I shared it with the leadership at Mass General Brigham Population Health, the Mass General Endocrine Division, and Mass General Brigham Health Plan. Then, I received support to set up the infrastructure and activate the Path to Lifestyle Change program. The 34-session lifestyle program includes nutrition, activity, and behavioral topics and uses trained expert registered dietitian coaches to deliver the program to groups of 10-15 people via telephone conference call. The program launched in January 2020, and the first participants will complete the 2-year program in January 2022.
What message do you have for patients during National Diabetes Awareness Month?
Diabetes can be prevented. Prediabetes is common. More than 88 million Americans have prediabetes- that is 1 out of 3 adults. Of those 88 million, more than 8 out of 10 people don’t know that they have it. Without taking action, many people with prediabetes could develop type 2 diabetes within five years.
Lifestyle programs aimed at a 7% weight loss and 150 minutes of activity per week have resulted in a 58% risk reduction in the development of diabetes—and 71% risk reduction for people over 60 years old.
If you develop type 2 diabetes, then lifestyle programs aimed at 10-15% weight loss can lead to diabetes remission, which means normal blood sugars without needing any diabetes medication— especially if you focus on lifestyle programs within the first six years of diagnosis.
If you’re a member of Mass General Brigham Health Plan, you can determine if you’re eligible to enroll in Path to Lifestyle Change by taking this test.
To learn more about how to enroll, click here.