Article Figures & Data
Tables
- Table 1.
Clinician Knowledge of Prediabetes Diagnosis and Treatment at an Academic Family Medicine Practice
Prediabetes Question Correct Answer Answered Correctly (N = 31) Fasting glucose range indicative of prediabetes 100 to 125 mg/dL29 21 (67.7%) Hemoglobin A1c range indicative of prediabetes 5.7 to 6.4%29 30 (96.8%) It is recommended that prediabetics lose what proportion of their starting weight? 5% to 7%29 10 (32.3%) How much physical activity per week should be recommended for patients with prediabetes, assuming they have no other health issues? 75 minutes vigorous; 150 minutes moderate29 21 (67.7%) How often should you routinely screen for diabetes? Every three years26,29 12 (38.7%) - Table 2.
Clinician Prediabetes Attitudes and Diabetes Prevention Program Awareness at an Academic Family Medicine Practice
Strongly Agree or Agree Neither Agree nor Disagree Strongly Disagree or Disagree Prediabetes attitudes Prediabetes is a significant public health issue 29 (93.6%) 2 (6.5%) 0 (0.0%) Most primary care providers consider screening for prediabetes to be a high priority 20 (64.5%) 5 (16.1%) 6 (19.3%) The diagnosis of prediabetes leads to further unnecessary investigation/testing 1 (3.2%) 5 (16.1%) 25 (80.6%) Diagnosing prediabetes is an effective way to increase patient awareness of their need for lifestyle modification 31 (100.0%) 0 (0.0%) 0 (0.0%) Evidence supports the effectiveness of treating prediabetes with lifestyle modification 31 (100.0%) 0 (0.0%) 0 (0.0%) Using metformin will reduce progression to diabetes 25 (80.6%) 4 (12.9%) 2 (6.5%) I am confident in my ability to manage prediabetes 27 (87.1%) 2 (6.5%) 2 (6.5%) DPP awareness I am familiar with National DPPs 14 (45.2%) 7 (22.6%) 10 (32.3%) I know how to refer a patient to a National DPP 15 (48.4%) 1 (3.2%) 15 (48.4%) I am aware of local organizations that offer National DPPs 13 (41.9%) 3 (9.7%) 15 (48.4%) I am aware of insurance plans that pay for National DPPs 5 (16.1%) 4 (12.9%) 22 (71.0%) I expect prediabetic patients who complete a National DPP will have long-term changes in their health behaviors 11 (35.5%) 13 (41.9%) 7 (22.6%) I expect prediabetic patients who complete a National DPP will have a reduced chance of progressing to diabetes 22 (71.0%) 6 (19.4%) 3 (9.7%) I expect prediabetic patients who complete a National DPP will have resolution of their prediabetes 5 (16.1%) 18 (58.1%) 8 (25.8%) DPP, National Diabetes Prevention Program.
- Table 3.
Clinician-Reported Frequency of Prediabetes Care Practices at an Academic Family Medicine Practice
Prediabetes Care Practice For What Proportion* of Your Prediabetic Patients Do you Perform the Following Management Practices… None Some Most Discuss metformin as a treatment option 0 (0.0%) 14 (45.2%) 17 (54.8%) Prescribe metformin 2 (6.5%) 19 (61.3%) 10 (32.3%) Recommend physical activity targets supported by national guidelines 0 (0.0%) 4 (12.9%) 27 (87.1%) Have patient set a weight loss goal of 5% to 7% of their current weight 4 (12.9%) 16 (51.6%) 11 (35.5%) Recommend nutritional counseling 0 (0.0%) 10 (32.3%) 21 (67.7%) Create a behavioral contract 25 (80.7%) 6 (19.4%) 0 (0.0%) Provide pamphlets or other written resources 7 (22.6%) 18 (58.1%) 6 (19.4%) Offer referral to a CDC-recognized National DPP 10 (32.3%) 21 (67.7%) 0 (0.0%) CDC, Centers for Disease Control and Prevention; DPP, Diabetes Prevention Program.
↵* Respondents selected between 0%, 25%, 50%, 75%, and 100%.
“None” indicates 0%; “Some” includes 25% and 50%; “Most” includes 75% and 100%.
- Table 4.
Demographic and Clinical Characteristics of Adult Patients with and without Prediabetes Diagnosis at an Academic Family Medicine Practice, 2014 to 2017
All Patients Prediabetes Diagnosis* N % N % 15,250 100 2,412 15.8% Demographic Age, years (mean, SD) 49.3 16.4 58.2 13.3 Female 8,606 56.4% 1,255 52.0% Race White 11,967 78.5% 1,790 74.2% Black/African American 2,474 16.2% 517 21.4% Asian 566 3.7% 76 3.2% AI/AN, Hawaiian, PI 79 0.5% 15 0.6% Unreported 164 1.1% 14 0.6% Health insurance Private 8,145 53.4% 1,109 46.0% Medicare 3,049 20.0% 780 32.3% Medicaid 3,011 19.7% 399 16.5% Tricare 291 1.9% 30 1.2% Financial assistance 164 1.1% 25 1.0% None 590 3.9% 69 2.9% Clinical characteristics BMI ≥25kg/m2 11,454 75.1% 2,122 88.0% Hemoglobin A1c test 10,095 66.2% 2,360 97.8% Diabetes diagnosis† 2,463 16.2% 561 23.3% AI/AN, American Indian/Alaska Native; BMI, body mass index; PI, Pacific Islander; SD, standard deviation.
↵* Prediabetes diagnosis defined as documented International Classification of Disease version 10 (ICD10) code R73.03 in patient chart.
↵† Diabetes diagnosis determined by ICD10 code in patient chart. For patients with prediabetes code this indicates a dual diagnostic codes.
- Table 5.
Prediabetes Care Cascade: Screening, Diagnosis, and Treatment Coverage of Adult Patients at an Academic Family Medicine Practice, 2014 to 2017 (N = 15,250)
Prediabetes Care Cascade Criteria n % USPSTF diabetes screening eligible Nondiabetic patient 12,787 83.8% Age 40 to 70 years + BMI ≥25 kg/m2 5,360 41.9% Screened Hemoglobin A1c within 3 years 4,068 75.9% Prediabetes diagnosed Hemoglobin A1c of 5.7 to 6.4% 1,437 35.3% Prediabetes documented Prediabetes ICD10 code 729 50.7% Prediabetes treatment Metformin prescribed 149 20.4% DPP referral 0 0.0% BMI, body mass index; DPP, Diabetes Prevention Program; ICD10, International Classification of Diseases, version 10; USPSTF, United States Preventive Services Task Force.
The sample size for each row serves as the denominator for the subsequent row.
