Community Pharmacy Lifestyle Program Could Improve Prediabetes Risk Factors

Individuals with prediabetes participating in a pharmacy-based, digital health-supported intervention exhibited significantly greater weight loss compared with patients receiving usual care, according to a study in Research in Social and Administrative Pharmacy.¹

“In recent years, community pharmacies have been increasingly involved in health promotion and disease prevention, including providing services for diabetes prevention,” wrote the authors of the study. “With a lower population to community pharmacist ratio of 1:10,200, compared with public health clinics (1:31,397) and hospitals (1:223,619), it provides the community with an easily available and accessible option to seek health care.”

A landmark cluster randomized controlled trial, known as the PRediabetes Intervention, Management, and Evaluation (PRIME) program, has recently demonstrated that a blended approach of pharmacist counseling and mobile technology can effectively drive weight loss in adults with prediabetes. Conducted across 16 community pharmacies in Malaysia, the PRIME program utilized a specialized mobile app for self-monitoring blood glucose, physical activity, and dietary intake, which transmitted real-time data to a dashboard accessible to pharmacists.¹

READ MORE: Pharmacist-Led Hypoglycemia Prevention Leads to Safer Prescribing in Diabetes

The study findings revealed that participants in the intervention group were twice as likely as those receiving usual care to achieve a clinically meaningful 5% reduction in body weight. Furthermore, those engaged with the PRIME program saw a significantly larger mean weight loss difference of 1.26 kg compared with the control group, with even greater results observed among participants who were more adherent to self-monitoring.

The strategic importance of the pharmacist’s role is underscored by the rising global prevalence of diabetes, which now affects over 537 million adults, the majority of whom live in low- and middle-income countries where health care facilities are often overcrowded and under-resourced.^1,2

“Decades of research have demonstrated that diabetes affects racial and ethnic minority and low-income adult populations in the US disproportionately, with relatively intractable patterns seen in these populations’ higher risk of diabetes and rates of diabetes complications and mortality,” wrote the authors of a study published in Diabetes Care.³ “With a health care shift toward greater emphasis on population health outcomes and value-based care, social determinants of health (SDOH) have risen to the forefront as essential intervention targets to achieve health equity.”

Unlike many other health care professionals, pharmacists benefit from frequent, direct interactions with patients and do not require prior authorization for consultations, making them uniquely accessible primary care providers.⁴ Research into pharmacist-led diabetes self-management education (DSME) has shown that structured interventions can significantly improve glycemic control, reducing average HbA_1c levels from 9.12% to 8.02% while enhancing patient knowledge and overall health-related quality of life (QOL), according to data published in Endocrine Practice.²

This push for pharmacy-based intervention aligns with national public health goals to advance health equity and address the root causes of disease disparities. SDOH, which include the conditions in which people live, learn, and work, account for 50% to 60% of health outcomes and are the primary contributors to disparities in diabetes care.^3,5

The CDC reports that racial and ethnic minority groups, as well as those with lower socioeconomic status, have historically suffered from higher rates of illness and death from diabetes.^3,5 The impact of socioeconomic status is so significant that a dose-dependent relationship has been identified where lower family income is directly associated with a higher risk of youth-onset type 2 diabetes (T2D) and increased all-cause mortality, according to a study published in JAMA Network Open.⁶

Pharmacists are ideally positioned to mitigate these risks because they often serve as the first point of health care entry for vulnerable groups who may not have a regular primary care provider or specialist.^1,3

“The pharmacist-led DSME program was effective in enhancing glycemic control, diabetes knowledge, self-management behaviors, and health-related QoL in patients with T2D,” wrote authors of the Endocrine Practice study.² “Findings from subgroup analyses underscore the potential of tailored pharmacist-led interventions to optimize outcomes in high-risk populations.”

Although digital health interventions show promise, their success often depends on the frequency of personalized communication and the practicability of the technology for the end user.⁴ Systematic reviews have found that telephone-based and mobile-based monitoring led by pharmacists can effectively improve medication adherence and clinical markers such as blood pressure and lipid profiles.

Moving forward, the integration of pharmacist-led digital health models represents a scalable and sustainable strategy to address the multidimensional challenges of diabetes prevention, as highlighted through the PRIME program.¹ They ensure that every person has an equitable opportunity to delay or prevent the onset of chronic disease with the pharmacist’s trusted guidance.²

“The study showed that the use of a digital health-supported, community pharmacy-based prediabetes intervention can be a feasible and effective way to reduce key risk factors for diabetes, in particular weight, BMI, and basal metabolic rate,” concluded the authors of the study.¹ “Implementation was found to be feasible with a high retention rate. Moving forward, long-term sustainability and economic aspects of the program should be evaluated.”

READ MORE: Diabetes Resource Center

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REFERENCES

1. Teoh KW, Ng CM, Chong CW, et al. A digital health-supported community pharmacy-based lifestyle intervention program for overweight or obese adults with prediabetes, the PRediabetes Intervention, Management and Evaluation (PRIME) Program: a cluster randomized controlled trial. Res Social Adm Pharm. 2025;22(2):272-282. https://doi.org/10.1016/j.sapharm.2025.10.002

2. Butt MD, Ong SC, Malik T, et al. Empowering diabetes care through pharmacist-led education: a randomized controlled trial in a low-resource setting. Endocr Pract. 2025;31(11):1414-1425. https://doi.org/10.1016/j.eprac.2025.06.022

3. Hill-Briggs F, Adler NE, Berkowitz SA, et al. Social determinants of health and diabetes: a scientific review. Diabetes Care. 2020;44(1):258-279. https://doi.org/10.2337/dci20-0053

4. Christy A, Fernanda F, Insani W, et al. Pharmacist-led digital health interventions for patients with diabetes: a systematic review. J Multidiscip Healthc. 2025;18:101-112. https://doi.org/10.2147/jmdh.s494584

5. Advancing health equity: diabetes. CDC. April 6, 2022. Accessed February 20, 2026. https://www.cdc.gov/diabetes/health-equity/index.html

6. Yen FS, Wei JCC, Liu JS, et al. Parental income level and risk of developing type 2 diabetes in youth. JAMA Netw Open. 2023;6(11):e2345812. https://doi.org/10.1001/jamanetworkopen.2023.45812