Study: Primary care docs deficient recognizing, preventing prediabetes

A survey of 1,000 randomly selected primary care physicians by researchers at Johns Hopkins revealed significant gaps in the respondent’s overall knowledge of risk factors, diagnostic criteria and recommended prevention practices for prediabetes.

Survey questions evaluated the physicians’ knowledge in three areas:

·      Risk factors that should prompt prediabetes screening, laboratory criteria for diagnosing prediabetes, and recommendations for prediabetes management.

·      Practice behaviors regarding prediabetes management.

·      Perceived barriers and potential interventions to improve prediabetes management.

The results revealed substantial gaps in primary care physicians’ knowledge in all three categories measured, according to the study’s authors.

For example:

• On average, respondents selected just 10 out of 15 correct risk factors for prediabetes, most often missing that African Americans and Native Americans are two groups at high risk.

• Only 42 percent of respondents chose the correct values of the fasting glucose and Hb1Ac tests that would identify prediabetes.

• Only 8 percent knew that a 7 percent weight loss is the minimum recommended by the American Diabetes Association as part of a diabetes prevention lifestyle change program.

According to the study’s authors, the results suggest that 25 percent of primary care physicians may be identifying people as having prediabetes when they actually have diabetes, which could lead to delays in getting those patients proper diabetes care and management.

Based on their findings, the researchers suggest strategies to address the physician knowledge gaps about prediabetes, as well as the system-level obstacles to preventing type 2 diabetes. These include better educating physicians about diabetes prevention, providing easier access for physicians and their patients to national diabetes prevention lifestyle change programs, increasing insurance coverage for such programs, and offering new tools to help primary care physicians improve the procedures and practices by which they diagnose and treat patients with prediabetes.

The U.S. Centers for Disease Control and Prevention says that 84 million Americans ages 18 or older have prediabetes but 90 percent don’t know it. If diagnosed early, experts say, lifestyle changes such as weight loss and regular exercise can prevent or delay the development of type 2 diabetes and the increased risks it poses for heart disease, stroke, kidney failure and nerve damage.