The CDC reports 98 million American adults (more than 1 in 3) have prediabetes, yet over 80% of them don’t know they have it. Additionally, 38.4 million Americans, or 11.6% of the U.S. population, have diabetes. Without proper prevention and management, diabetes can significantly reduce an individual’s quality of life. The total annual cost of diabetes is $413 billion, accounting for 25% of national healthcare expenses, making it the costliest chronic condition in the United States.

For over a decade, the CDC has partnered with NACDD to progressively steward State Health Departments, State Medicaid Agencies, managed care plans, and delivery partners in developing effective public payment policies and sustainable financing strategies for diabetes risk reduction among the Medicaid population, or 26% of Americans. Medicaid funding enhances access to the National Diabetes Prevention Program (National DPP) lifestyle change program (LCP) and Diabetes Self-Management Education and Support (DSMES) for a population at high risk for developing diabetes. Since NACCD began this initiative, Medicaid coverage for the National DPP LCP has risen by 1400%, with 30 states now successfully providing covered services.

In February 2025, NACDD began enhancing collaboration with five competitively selected State Health Departments and their partners, including Delaware, Illinois, Maryland, Minnesota, and Montana, to boost access and enrollment of Medicaid beneficiaries in diabetes risk reduction programs. This year, NACDD is investigating the combined impact of evidence-based diabetes risk reduction strategies and nutrition programs on sustainability and scale. One initiative, “Food is Medicine,” focuses on screening and addressing nutrition-related health needs. This public health approach highlights the importance of nutrition in preventing, managing, and treating diabetes. By integrating nutritional support into diabetes risk reduction interventions, NACDD will explore more ways to sustainably empower Medicaid beneficiaries to lead healthier lives. Through this ongoing seminal work, NACDD is committed to engaging with people and partners where they are to ensure those at high risk of living with prediabetes and diabetes are not left behind. Stay tuned for more updates as this work continues to progress by visiting the National DPP Coverage Toolkit.