Welcome to a webinar hosted by the
National Diabetes Prevention Program or
National DPP on using hemoglobin
A1C or A1C to meet program
requirements for both participants and
organizations.
Agenda. This webinar serves as an
overview on the use of A1C values within
the national DPP. As part of today's
webinar, we will introduce the two main
uses of A1C within the program.
#1 how to use A1C to
determine lifestyle change program or
LCP eligibility, and
#2 how to use A1C as an
optional outcome measure, including
walking through data reporting
requirements. We'll then take you
through a demonstration on how to report
A1C values to CDC.
Uses of A1C values.
Organizations recognized by CDC to
deliver the national DPP LCP
can use A1C values in two ways.
To determine participant eligibility and
to measure risk reduction using this
optional outcome.A1C is
1 way to determine if an adult 18 or
over is at risk of developing type 2
diabetes and if that adult is eligible
to participate in the national DPP.
We will go into specific requirements
later in the webinar. In addition to
eligibility, A1C is used as an optional
reporting measure by program delivery
organizations to show a reduced risk of
type 2 diabetes.
A1C for LCP eligibility.
We will now go into the specifics of
using A1C to determine participant
eligibility. Participants in the
national DPP LCP must meet several
requirements to be eligible for the
program. All program participants
must be 18 years of age or older, have
a body Mass Index BMI of greater
than or equal to 25.Greater than or
equal to 23 if an Asian American person.
And not be pregnant. Participants must
then meet one of the three eligibility
requirements, either a positive
screening for prediabetes, a previous
diagnosis of gestational diabetes or
elevated blood glucose in the pre
diabetes range based on the results of
one of three blood tests.These tests
include a fasting plasma glucose
test, an oral glucose tolerance
test or an A1C test. For
today, we are only going to look at A1C
levels, but please see the Diabetes
Prevention Recognition Program DPRP
Standards for full list of eligibility
requirements.If a person has an
A1C level in the
5.7% to
6.4% range, they have pre
diabetes and can participate in the
national DPP LCP.
Note that this test needs to be done
within one year before participant
enrollment in the program. If the
participant is enrolled in the Medicare
Diabetes Prevention Program
MDPP, the blood test result
cannot be self reported.
A1C as an outcome measure.
The eligibility determination is
distinct and separate from using A1C as
an optional outcome measure for
recognition status determination. To
achieve and maintain recognition status,
CDC recognized Organizations must
meet several requirements, including
showing that there has been a reduction
in the risk of developing type 2
diabetes among people completing the
national DPP.
Organizations must show that 60% of
all persons completing the LCP
achieved one of three outcomes after the
cohort began, at least a 2%
reduction in A1C.A minimum
of 5% weight loss 12 months after the
participant cohort began, or at least
4% weight loss combined with at least
150 minutes a week on average
of physical activity.All three of these
measures showed reduced risk of type 2
diabetes among participants.
Specific reporting requirements for CDC
Recognized Organizations.There
are several specific data reporting
requirements for organizations if they
are using A1C as an outcome
measure. First, a pre and post
intervention A1C value must be
collected. These values can be self
reported except for MDPP participants.
Please visit the Centers for Medicare
and Medicaid Services CMS
MDPP website at cms
org.force.com/
MDPP For more information on
MDPP requirements. If no beginning or
ending value is recorded, organizations
should use 999 as a default
value and not use A1C for this
participant. If choosing to include this
information, the Pre intervention or
baseline A1C measure must
result from a test taken within a year
before entering the program and be
reported within 14 days after the first
session attended by the participant.
Baseline entries must be in the pre
diabetes range of
5.7% to
6.4%.The
ending or post intervention value should
be collected and reported before the
final data submission for each year of
the program. Post intervention A1
C measures must be recorded in months 9
through 12 to be used for evaluation.
To determine the date of your last
session, organizations can use the
Understanding and Managing Sequences
resource and webinar on the National
DPP Customer Service Center
CSC website.
Once final data are submitted, CDC will
determine if participants met the .2
percent A1C reduction.
One final note, A1C can only
be used with data submissions under the
2021 DPRP standards going
forward. CDC will not allow the
retroactive addition of A1C
values on previous data submissions
under previous versions of the DPRP
standards.
A1C reporting demonstration.
Organizations upload and submit data to
CDC using the DPRP Data
Submission and Administration Portal.
A data entry spreadsheet template in
CSV format is available on
the CSC to help with the submission.
The top row of the template contains the
required variables as column headings.
The column labeled A1C is where you will
enter the collected A1C values.
To prevent errors from creating a flag
in your data reporting file, the pre
intervention entry should be in the
range of 2.5 to
18 or
999 if the value is not reported.
Note that only an A1C of
5.7% to
6.4% can be used to
qualify for the program.Even
if your organization is not reporting a
pre intervention value for a
participant, keep in mind that cells in
the spreadsheet cannot be left blank.
The post intervention value should be
associated with the session held in
months 9 through 12 of the participants
timeline and can be either within or
below the prediabetes range.
Any entries above the pre diabetes range
will be flagged and a member of the data
team will contact you because the
participant is no longer eligible for
the program.Records for sessions
held in between the reporting of the pre
and post intervention values should have
the default value of 999 entered.
Entering valid A1C values for these
sessions, however, will not flag an
error, they simply won't be used. If
multiple values are entered for records
associated with months 9 through 12, the
lowest value will be used for the
reduction calculation.
Thank you. In summary, A1C can
be used in two different ways. One, to
determine participant eligibility in the
national DPP LCP and
two, as an outcome measure for
organizations to show their program is
leading to reduction in participants
risk for type 2 diabetes. For more
information on using A1C, please review
the DPRP standards found in the
CSC website at National
DPPCSC.
cdc.gov. If you have further
questions, please reach out to a CDC
representative by visiting the CSC
and submitting a Technical Assistance
request. To submit a request, you will
need to complete a brief profile by
selecting Login and then
register. Once logged in,
select Technical Support
Request on the home page.
Thank you for your time and for
participating in the national DPP.