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Preventing Diabetes in the Workplace

Effects of Coaching and Monetary Incentives

Raymond, Lawrence W. MD, ScM; Roy, Deborah M. RN, MSN; Mullinax, Shannon L. PA; Yanni, Allyson NP; Pentek, Karen C. RN, MSN; Isaacs, Sarah E. RN

Journal of Occupational and Environmental Medicine: July 2019 - Volume 61 - Issue 7 - p e308–e311
doi: 10.1097/JOM.0000000000001611

Objective: Prevention of diabetes demonstrated in the diabetes prevention program has not been thoroughly evaluated in workplace settings.

Methods: Glycemic control was assessed by glycated hemoglobin (HbA1c) and its impact on 5-year incidence of diabetes and prediabetes prevalence, in wellness program participants (WPP) of (Group A, with) or (Group B, without) health coaching and monetary incentives.

Results: HbA1c fell in Group A WPP (5.52 ± 0.60 vs 5.58 ± 0.36 SD, P = 0.04) as did prediabetes. Incident diabetes was less than expected (24 vs 74, P < 0.001). HbA1c increased in Group B WPP (5.37 ± 0.40 SD vs 5.58 ± 0.54, P < 0.001) and prediabetes increased from 28 to 36 (P < 0.001).

Conclusions: Health coaching and monetary incentives improved glycemic control over 5 years, an improvement not observed in WPP without these interventions.

HEALTHWORKS Division, Atrium Health, Charlotte (Dr Raymond, Ms Roy, Ms Mullinax, Ms Yanni, Ms Pentek, Ms Isaacs); and University of North Carolina at Chapel Hill (Dr Raymond), North Carolina.

Address correspondence to: Lawrence W. Raymond, MD, ScM, Atrium Health, 4135 South Stream Blvd., Charlotte, NC 28217 (

Funding: No external funding was provided.

Author contributions: All authors had full access to the data included in this report, and to the manuscript, for which L.W.R. is the guarantor and takes responsibility for the integrity of the data and accuracy of the data analysis.

Clinical Significance: Health coaching and monetary incentives improved glycemic control over 5 years in wellness program participants (WPP). Prediabetes decreased by 40% and incident diabetes was only 32% of that expected. No such improvements were observed in WPP not provided with such interventions. However, blood lipoproteins improved in both groups.

No potential conflicts of interest were reported.

Copyright © 2019 by the American College of Occupational and Environmental Medicine