circumference, fasting blood glucose, and two-hour post prandial blood glucose, which is graded as strong evidence of having a lower risk of developing type 2 diabetes. A second, independent systematic review of diabetes prevention using nutrition therapy conducted in Europe found that individuals who received the lifestyle interventions had a 47-percent reduced risk of developing type 2 diabetes. (6) The Medicare program currently provides coverage for screening and identifying beneficiaries with pre-diabetes but does not provide adequate services to such beneficiaries to help them prevent or delay the onset of diabetes. 3. Medicare coverage of medical nutrition therapy services for people with pre-diabetes and risk factors for developing type 2 diabetes (a) In general Section 1861 of the Social Security Act ( 42 U.S.C. 1395x ) is amended— (1) in subsection (s)(2)(V), by striking a beneficiary with diabetes or a renal disease and inserting an individual with diabetes, pre-diabetes (as defined in subsection (yy)(4)), or a renal disease, or an individual at risk for diabetes (as defined in subsection (yy)(2)), in the matter preceding clause (i)