Survey of primary care providers’ knowledge of screening for, diagnosing and managing prediabetes
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Prediabetes affects 86 million US adults, but primary care providers’ (PCPs') knowledge, practices, attitudes and beliefs toward prediabetes are unclear.
Assess PCPs’ (1) knowledge of risk factors that should prompt prediabetes screening, laboratory criteria for diagnosing prediabetes and guidelines for management of prediabetes; (2) management practices around prediabetes; (3) attitudes and beliefs about prediabetes.
Self-administered written survey of PCPs.
One hundred forty of 155 PCPs (90%) attending an annual provider retreat for academically affiliated multispecialty practices in the mid-Atlantic region.
Descriptive analyses of survey questions on knowledge, management, and attitudes and beliefs related to prediabetes. Multivariate logistic regression was used to determine the association between provider characteristics (gender, race/ethnicity, years since training, specialty and provider type) and knowledge, management, and attitudes and beliefs about prediabetes.
Six percent of PCPs correctly identified all of the risk factors that should prompt prediabetes screening. Only 17% of PCPs correctly identified the laboratory parameters for diagnosing prediabetes based on both fasting glucose and hemoglobin A1c. Nearly 90% of PCPs reported close follow-up (within 6 months) of patients with prediabetes. Few PCPs (11%) selected referral to a behavioral weight loss program as the recommended initial management approach to prediabetes. PCPs agreed that patient-related factors are important barriers to lifestyle change and metformin use. Provider characteristics were generally not associated with knowledge, management, attitudes and beliefs about prediabetes in multivariate analyses.
Addressing gaps in knowledge and the underutilization of behavioral weight loss programs in prediabetes are two essential areas where PCPs could take a lead in curbing the diabetes epidemic.
KeywordsPrediabetes Prevention Primary care
Compliance with ethical standards
Dr. Eva Tseng is supported by training grant T32HL007180–41. Dr. Raquel Greer is supported by National Institutes of Health grant K23DK094975. This study received analytic support from the Baltimore Diabetes Research Center (National Institutes of Health, National Institutes of Diabetes and Digestive and Kidney Disease, grant no. P30 DK079637).
This work was presented at the Society of General Internal Medicine Annual Meeting in May 2016.
Conflict of interest
The authors declare that they do not have a conflict of interest.
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