Patient age, body mass index, gender, race, comorbidities can affect prediabetes diagnosis

Patient age, body mass index, gender, race and comorbidities might affect accurate diagnosis of prediabetes in primary care settings, according to research presented at ENDO 2022, the Endocrine Society’s annual meeting in Atlanta, Georgia.

Prediabetes is reversible through medications and lifestyle changes, and a correct and timely diagnosis might help prevent stroke and heart disease. However, the federal Centers for Disease Control and Prevention (CDC) estimate that 80% to 90% of patients with prediabetes are unaware of their diagnosis, researcher An V. Nguyen, MD, said in a news release published June 11.

Nguyen, a resident focusing on general endocrinology at Scripps Clinic/Scripps Green Hospital in La Jolla, California, led a retrospective chart study of 20,061 patients at Scripps Clinics’ five locations in southern California for 2018 and 2019. Researchers identified all faults who qualified for a prediabetes diagnosis based on fasting blood glucose or HbA1c levels. Those with a billable condition were included in the intervention group. The others were part of the control group. The researchers looked at whether factors such as the patients’ age, BMI, gender, race and certain comorbidities are associated with being correctly diagnosed, according to the news release.

Among the patients, 7,575 were correctly diagnosed with prediabetes. Only 37% of the patients were diagnosed with prediabetes or impaired fasting blood glucose. Of those, 93% qualified by HbA1c levels.
Having obesity or overweight, being female, of Asian race, and living with comorbidities including lipid disorders and conditions requiring steroids, were linked to a correct diagnosis of prediabetes. Other factors, such as being male, Black and having comorbidities requiring immunosuppressants, antineoplastics and iron replacements were negatively correlated with a correct prediabetes diagnosis, according to the study.

“This study demonstrates that the condition is often appropriately screened, but diagnosis and treatment were less consistent,” Nguyen said in the news release. Healthcare providers seem to rely heavily on the HbA1c test, which measures average blood glucose over three months, to make the diagnosis, Nguyen said.

“Overall, this research reveals inherent biases that health care providers might have when diagnosing prediabetes and serves as a call for reflection within the provider’s practice,” Nguyen said.