Name of the Procedure:

Medicare Diabetes Prevention Program (MDPP) Session
(Also known as G9891 HCPCS Code Session)

Summary

The Medicare Diabetes Prevention Program (MDPP) session is part of a structured lifestyle intervention designed to help patients who are at high risk for type 2 diabetes. These sessions are educational meetings focused on diet, exercise, and behavior changes to promote weight loss and a healthier lifestyle.

Purpose

Medical Conditions/Problems:

• Prediabetes
• High risk of developing type 2 diabetes

Goals/Expected Outcomes:

• Reduce the risk of developing type 2 diabetes
• Achieve sustainable weight loss
• Promote healthier living through diet and exercise

Indications

Symptoms/Conditions Warranting the Procedure:

• Diagnosed prediabetes (elevated blood sugar levels not yet high enough to be classified as type 2 diabetes)

Patient Criteria:

• BMI of 25 or higher (23 in Asians)
• Hemoglobin A1c between 5.7% and 6.4%, fasting plasma glucose of 100-125 mg/dL, or 2-hour plasma glucose of 140-199 mg/dL (after a 75 mg glucose load)
• No previous diagnosis of type 1 or type 2 diabetes
• Not end-stage renal disease (ESRD)

Preparation

Pre-Procedure Instructions:

• No special preparations are typically required, but patients should be ready to engage in lifestyle changes and commit to attendance.

Diagnostic Tests/Assessments:

• Initial screening for eligibility, including lab tests for blood glucose levels.

Procedure Description

Step-by-Step Explanation:

1. Patient attends a scheduled group session, either in person or virtually.
2. Sessions are led by a trained lifestyle coach.
3. Topics covered may include nutrition, physical activity, and behavior modification.
4. Group discussions on overcoming barriers to lifestyle changes.
5. Periodic tracking of weight and physical activity.
6. Support and motivation from group interactions.

Tools/Equipment/Technology:

• Educational materials (pamphlets, videos, presentations)
• Weighing scales
• Activity tracking tools (e.g., pedometers, fitness apps)

Anesthesia/Sedation:

• Not applicable.

Duration

• 1-hour sessions, typically once a week initially, with frequency decreasing over time.

Setting

• Community centers, outpatient clinics, or online platforms.

Personnel

• Trained lifestyle coaches
• Dietitians or nutritionists (depending on the session focus)

Risks and Complications

Common Risks:

• Minimal physical risk
• Potential for minor discomfort due to increased physical activity

Rare Risks:

• None significant

Possible Complications:

• Limited to subjective reports of soreness or fatigue from exercise.

Benefits

Expected Benefits:

• Reduced risk of developing type 2 diabetes by nearly 60%
• Sustainable weight loss
• Improved overall health and well-being

Realization Timeline:

• Benefits can be seen gradually over weeks to months of consistent participation.

Recovery

Post-Procedure Care:

• Continued lifestyle changes as instructed during sessions
• Regular follow-up meetings to maintain progress

Expected Recovery Time:

• No recovery time needed, but ongoing commitment is necessary.

Restrictions/Follow-up:

• Participation in maintenance sessions and regular monitoring of progress.

Alternatives

Other Treatment Options:

• Pharmacological interventions (e.g., metformin)
• Independent, self-guided diet and exercise programs

Pros and Cons of Alternatives:

• Pharmacological interventions may have side effects and typically don’t address the root lifestyle causes.
• Self-guided programs may lack structure, support, and accountability.

Patient Experience

During the Procedure:

• Patients may feel motivated and supported by peers.
• Potential initial discomfort from increased physical activity.

After the Procedure:

• Improved sense of well-being.
• Might experience muscle soreness from physical activity.

Pain Management/Comfort Measures:

• Encouragement to start physical activities gradually.
• Adequate support and motivational techniques from lifestyle coaches.