Primary care doctors need more education about prediabetes risk factors

A new survey suggests primary care physicians need more medical education to help them better identify patients at risk for developing diabetes.

Although the sample was small, it found most primary care doctors couldn't identify all of the risk factors for prediabetes, which should serve as a wake-up call, according to Johns Hopkins researchers.

A report of the survey's findings was published in the Journal of General Internal Medicine. The researchers surveyed 140 primary care providers attending an annual retreat for academically affiliated multispecialty practices. The vast majority could not identity all 11 risk factors that qualify patients for prediabetes screening.

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Only 6% correctly identified all of the risk factors that should, based on guidelines from the American Diabetes Association (ADA), prompt screening of patients. Only 17% correctly identified the fasting glucose and HbA1C laboratory values for diagnosing the condition that affects an estimated 86 million U.S. adults.

On average, the doctors selected eight out of the 11 correct risk factors for prediabetes screening. The survey also found nearly one-third of the doctors were unfamiliar with the ADA’s guidelines.

"Although this survey was conducted among primary care providers from a large academically-affiliated practice and may not represent providers from other types of practice settings, 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," Eva Tseng, M.D., an assistant professor at the Johns Hopkins University School of Medicine and the paper's first author, said about the study.

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It’s estimated that 70% of people with prediabetes will eventually develop type 2 diabetes, according to the Centers for Disease Control and Prevention and ADA experts. Preventive measures—such as changes in diet and physical activity and the prescription of metformin to help control blood sugar levels—have proven effective in preventing the progression of prediabetes to type 2 diabetes, according to the ADA.

An estimated 90% of individuals with prediabetes, however, are unaware of their condition.

"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 Nisa Maruthur, assistant professor of medicine at Johns Hopkins and the paper's senior author.