Journal of General Internal Medicine

, Volume 32, Issue 11, pp 1172–1178 | Cite as

Survey of primary care providers’ knowledge of screening for, diagnosing and managing prediabetes

  • Eva Tseng
  • Raquel C. Greer
  • Paul O’Rourke
  • Hsin-Chieh Yeh
  • Maura M. McGuire
  • Jeanne M. Clark
  • Nisa M. Maruthur



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.

Main measures

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.

Key results

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.


Prediabetes 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).

Prior presentations

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.

Supplementary material

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Online Table 1 (DOCX 19 kb)
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Online Table 2 (DOCX 19 kb)
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Online Table 3 (DOCX 18 kb)
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Online Table 4 (DOCX 19 kb)
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Online Fig 1 Number of correct risk factors for prediabetes screening selected by PCPs. (DOCX 23 kb)
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ESM 1 (DOCX 28 kb)


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Copyright information

© Society of General Internal Medicine 2017

Authors and Affiliations

  • Eva Tseng
    • 1
  • Raquel C. Greer
    • 1
    • 2
  • Paul O’Rourke
    • 3
  • Hsin-Chieh Yeh
    • 1
    • 2
    • 4
  • Maura M. McGuire
    • 1
    • 5
  • Jeanne M. Clark
    • 1
    • 2
    • 4
  • Nisa M. Maruthur
    • 1
    • 2
    • 4
  1. 1.Division of General Internal MedicineThe Johns Hopkins UniversityBaltimoreUSA
  2. 2.Welch Center for Prevention, Epidemiology, & Clinical ResearchThe Johns Hopkins UniversityBaltimoreUSA
  3. 3.Division of General Internal MedicineJohns Hopkins Bayview Medical CenterBaltimoreUSA
  4. 4.Department of EpidemiologyThe Johns Hopkins University Bloomberg School of Public HealthBaltimoreUSA
  5. 5.Johns Hopkins Community PhysiciansBaltimoreUSA

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