Provider practices in prediabetes intervention and diabetes prevention: application of evidence-based research in the medical office setting

A cross-sectional study was performed to determine if evidence-based research in prediabetes management is utilized in the medical office setting in an effort to reduce the incidence of type 2 diabetes, and to determine whether any particular demographic variables including body mass index (BMI) and provider type (physician and nonphysician) predict referrals for prediabetes management (P = .05). Electronic medical records (n = 82 317) were examined for International Classification of Diseases (ICD) codes and keywords disclosing a diagnosis of prediabetes. The records of individuals with diagnosed prediabetes were subsequently examined for keywords and ICD codes for lifestyle intervention. Logistic regression was utilized to determine whether any particular demographic factors significantly predicted whether medical providers will provide recommendations or referrals for lifestyle management of prediabetes. Age, BMI, and race were found to be significant predictors for recommendations/referrals, although overall rates of recommendation or referral were poor. Provider education and enhancements in organizational policy related to referral procedures and continuity of care from the clinical setting to the community health setting are crucial in promoting early interventions in prediabetes to offset the current projections for an increase in diabetes incidence.