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63-6-1 Monitoring the Progress of Program Implementation

Monitoring an implemented program is part of the program itself. It allows to know if the goals set are being met and if the program itself is accomplishing the results planned.

The proposed National Diabetes Prevention Program (NDPP) needs to monitor specific values. Basically, if we take into consideration some of the factors that make a patient eligible for the program, should be the same factors or values that should be monitored as progress.

According to the NDPP the inclusion criteria or qualifying factors to the programs are:

1. Being physically inactive. The activity of the patients should be monitored and recorded.

2. Having high blood pressure— 140/90 mmHg or above—or being treated for high blood pressure. The blood pressure should be recorded and monitored.

3. Having HDL, or “good,” cholesterol below 35 mg/dL, or a triglyceride level above 250 mg/dL. These are simple values to be measured and followed for progress.

4. Having impaired fasting glucose (IFG) or impaired glucose tolerance (IGT) on previous testing. These are other set of values that should be followed for progress.

5. Having other conditions associated with insulin resistance, such as severe obesity or acanthosis nigricans. Obesity is easy followed, basically having a scale is all needed for this purpose.

6. Other values that should be monitored are: A1C hgb, fasting glucose, and possibly applying a questionnaire about the teaching taught.

Monitoring progress in this way should be easy. This kind of information is routinely monitored during regular medical visits even outside a specific program.

Nonetheless, problems can always arise. Failure to monitor these values would bind the program to failure. The main failure however, could come from having a very low or poor enrollment into the program. For this reason and according to the expected enrollment pace, enrollment should be one of the main monitoring tools.

Monitoring enrollment is more challenging than monitoring the other parameters mentioned. Enrollment, first of all, will be a planned parameter that is based on assumptions and calculations. Nonetheless, if these calculations are well done, the idea of the expected enrollment could be accurate, and failure prevented. A low enrollment would make the entire program a complete failure, even if the prior mentioned parameters appear to be a success, hence the importance to monitor enrollment.