According to the CDC's National Diabetes Statistics Report, 115.2 million U.S. adults have prediabetes, which is more than 2 in 5 American adults. And 8 in 10 of them don't know they have it.
Run that against your census. A meaningful slice of your workforce is sitting at a fork in the road right now, with no idea the fork exists.
What prediabetes actually means, in plain English
Prediabetes means blood sugar is higher than normal but not high enough to be diagnosed as type 2 diabetes. It's usually identified with an A1C test, a simple blood test that reflects average blood sugar over roughly three months. According to the CDC, an A1C of 5.7% to 6.4% indicates prediabetes, and below 5.7% is considered normal.
Prediabetes usually has no symptoms. Nobody feels it, which is the whole reason the awareness gap is so wide.
It's also not a verdict. Prediabetes is a risk state, not a diagnosis of diabetes, and plenty of people move back out of it. What moves them is behavior: what they eat, how much they move, how they sleep, and how they handle stress.
Why prediabetes in the workplace is the cheapest intervention you'll ever get
Prevention costs a fraction of treatment, and the gap is not subtle. According to the CDC, people diagnosed with diabetes incur about $19,700 a year in medical expenses on average, roughly 2.6 times what a person without diabetes incurs. Prediabetes, by contrast, responds to coaching, food, and movement.
Zoom out and the numbers get louder.
It isn't only a plan-spend story. CDC puts the indirect cost of diabetes at $305 billion, including $157 billion in lost productivity from illness. In HR language: absence, presenteeism, and reduced capacity.
The math is unusually simple. Every employee who stays out of a type 2 diagnosis is a claim you never pay and a productivity hit you never absorb. That's the same logic behind chronic disease management program ROI for employers, applied one step earlier.
What the Diabetes Prevention Program (DPP) model actually is
The DPP is a research-tested lifestyle change program, delivered nationally today as the CDC's National Diabetes Prevention Program (National DPP). It runs a full year. Participants meet about weekly for the first six months, then once or twice a month for the second six, with a trained lifestyle coach and a small peer group.
According to the CDC, the randomized trial behind the model reduced participants' chances of developing type 2 diabetes by 58% compared with placebo, and by 71% among people aged 60 and older. That was nearly twice the reduction seen in the group taking metformin, at 31%.
| DPP element | What it looks like | Why it matters to you |
|---|---|---|
| Duration | 12 months total, weekly for about 6 months, then monthly | Habit change needs runway, not a sprint |
| Coach | A trained lifestyle coach using a CDC-approved curriculum | Consistency plus adaptation to the group |
| Cohort | A small peer group with shared goals | Social accountability drives attendance |
| Curriculum | Eating, activity, stress, eating out, holidays, getting back on track after a slip | Targets the moments where people actually quit |
| Delivery | In person, online, distance learning, or a combination | Reaches shift, hourly, and remote employees |
The durability data is the part worth showing your CFO. According to the CDC, a 10-year follow-up study found participants were still about one-third less likely to develop type 2 diabetes a decade later, and those who did develop it delayed onset by roughly four years.
That durability is what happens when a program is built around how habits actually work rather than information delivery.
What employers get wrong about diabetes prevention
Most employers who do something about prediabetes make one of five mistakes. None are stupid. They're mismatches between the problem and the tool.
How this connects to the GLP-1 conversation you're already having
GLP-1 coverage and diabetes prevention are not competitors. They're two points on the same curve, and the prediabetes population sits upstream of the one driving your specialty spend.
Here's the connection that matters. In the STEP 1 trial extension published in Diabetes, Obesity and Metabolism, participants regained two-thirds of their prior weight loss in the year after treatment and lifestyle support were withdrawn.
That's the same argument for pairing behavioral coaching with GLP-1 coverage, and it's why prevention shouldn't wait for the coverage question to settle.
Practical sequencing: fund prevention for the prediabetes population, fund coaching alongside whatever GLP-1 coverage you land on, and stop treating those as competing line items.
Where Avidon Health fits
Avidon builds the behavioral layer DPP-style programs depend on: live and digital coaching, structured courses, habit builders, and challenges, all grounded in cognitive behavioral training rather than generic wellness content. The target behaviors here are the unglamorous ones, and habit problems need repetition, personalization, and a coach who notices when someone goes quiet.
Two numbers from our own data are worth putting in front of a benefits committee. In a six-month behavior-change study of more than 1,100 participants managing diabetes, 91% reported feeling more confident and in control of their condition and 86% reported improved motivation to manage it. And in a multi-year outcomes study of more than 1,500 individuals tracked through annual biometric screenings, with Avidon as the only intervention, the 2023 cohort showed average reductions in fasting glucose of roughly 16 mg/dL alongside drops in BMI, weight, and cholesterol.
Read those as reported program outcomes, not as a randomized trial, and note that per-metric sample sizes in the biometric cohort run in the low hundreds. Our full health coaching efficacy data has the methodology.
For small and mid-market employers, the advantage is speed and fit. You can launch without a 500-employee minimum and extend the same well-being infrastructure to your whole population. See our employee well-being solutions for employers.
