With more than 2,500 facilities serving 10,000 communities that run the gamut from big-city downtowns to small rural sites, the YMCA (Young Men's Christian Association) could turn out to be a powerful tool in the fight to prevent diabetes.

And if further research shows that YMCA-like civic institutions work well at disseminating diabetes prevention skills, the responsibility for educating people about the disease could spread way beyond hospitals, clinics, and doctors' offices. 

That's the conclusion reached by researchers at the Indiana University School of Medicine after they tracked 92 pre-diabetic persons who attended courses at two YMCAs located in greater Indianapolis.

Participants were divided into two groups of 46. One group visited the first YMCA and was given standard diabetes prevention advice, which consisted of regular educational materials such as handouts and brochures. 

The second "intervention" group attended 16 classroom-type meetings at the other YMCA over a four- to five-month period. Each session lasted 60 to 90 minutes and covered such topics as goal setting, self-monitoring, and problem solving, as well as exercise techniques. 

Although the 92-person sample was small, results were gratifying. Follow-ups made four to six months after the study showed that the "intervention" participants had lost six percent of their body weight (an average of 12.5 pounds) versus a two percent body weight decrease in the group that had received standard diabetes prevention advice. 

"In previous studies, a five percent weight loss was associated with a 58 percent reduction in risk of developing diabetes," said the study's leader, Ronald Ackermann, MD, MPH, an assistant professor of medicine at Iowa University and an affiliated scientist of the Regenstrief Institute. He added that the weight loss was accompanied by "significant reductions of total cholesterol."

Researchers' interest in testing the usefulness of community-based organizations like the YMCA to deliver diabetes prevention advice is based on the growing number of Americans (an estimated 60 million) who are believed to be pre-diabetic. People with pre-diabetes tend to be overweight and have high levels of blood sugar and insulin resistance-classic precursors to type 2 diabetes.

"By lowering the cost of and expanding the accessibility to diabetes prevention services, the YMCA may not only serve to increase the number of individuals with pre-diabetes who have access to and can pay for evidence-based diabetes prevention; it may also provide a compelling model for health plan reimbursement," said Dr. Ackerman. 

"This provides yet another compelling reason to develop and test novel strategies that link community-based program delivery with existing clinical services that could help to identify and activate more adults with pre-diabetes."

The study was published in the October 2008 issue of the American Journal of Preventive Medicine.