Many Primary Care Docs May Miss Prediabetes
MONDAY, July 24, 2017 -- Most primary care doctors can't identify all 11 risk factors for prediabetes, a small new survey finds.
Researchers from Johns Hopkins University said their findings should prompt doctors to learn more about this condition that affects an estimated 86 million adults in the United States and could eventually lead to type 2 diabetes.
"We think the findings are a wake-up call for all primary care providers to better recognize the risk factors for prediabetes, which is a major public health issue," said study first author Dr. Eva Tseng in a university news release. She's an assistant professor at Hopkins' School of Medicine.
It's estimated that 90 percent of those with prediabetes are unaware that they have the condition, according to the U.S. Centers for Disease Control and Prevention.
The American Diabetes Association (ADA) explains that changes in diet, exercise and certain medications can help prevent people with prediabetes from going on to develop type 2 diabetes.
To investigate why so many people with prediabetes go undiagnosed, the researchers asked primary care doctors attending a medical retreat to complete a survey testing their knowledge of key risk factors for the condition.
The ADA has guidelines that list a total of 11 specific risk factors that determine if a patient should be screened for prediabetes. They include physical inactivity, a first-degree relative with diabetes, high blood pressure, and a history of heart disease.
A total of 140 doctors took the survey. Nearly one-third of those surveyed weren't even familiar with the ADA's prediabetes guidelines. Only 6 percent were able to identify all 11 risk factors. On average, the doctors could correctly identify just eight of the warning signs.
The doctors also had to identify the healthy range for glucose tests results used to diagnose prediabetes as well as recommendations about weight loss and physical activity for people with the condition.
Only 17 percent identified the correct values for fasting glucose and another key measure of glucose, known as HbA1c, which are used to diagnose prediabetes, the study authors said.
Only 11 percent of the doctors said they would refer a patient to a behavioral weight loss program, even though that's what the ADA recommends. But 96 percent did choose to provide counseling on diet and physical activity.
Most of the doctors said they wouldn't prescribe metformin for prediabetes. But in 2017, the ADA recommended that metformin be considered for patients with prediabetes who haven't reduced their risk for diabetes through lifestyle changes alone.
"Primary care providers play a vital role in screening and identifying patients at risk for developing diabetes. This study highlights the importance of increasing provider knowledge and availability of resources to help patients reduce their risk of diabetes," said study senior author Dr. Nisa Maruthur, an assistant professor of medicine at Hopkins' School of Medicine.
The results were published recently in the Journal of General Internal Medicine.
The U.S. Centers for Disease Control and Prevention provides more information on prediabetes.
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Posted: July 2017