pre diabetics

Family doctors urged to do more to identify prediabetes

by Barbara Hewitt on November 10, 2016

Family doctors should be encouraged to help identify and treat prediabetes as a means of preventing people from going on to develop type 2 diabetes, new research suggests.

Not enough of them are doing so despite national guidelines suggesting that such a move as screening is a key part of bringing the number of type 2 diabetics down, says a new report from scientists at the University of Florida in the United States.

doctorIt found that only about half of family physicians report following national guidelines for screening patients for prediabetes and they also said that patient factors, such as sustaining a patient’s motivation to make lifestyle changes, were significant barriers to diabetes prevention.

It is estimated that more than a third of US adults have prediabetes, but most don’t know it. Prediabetes, which is characterised by having blood glucose concentrations higher than normal, but not high enough for a diabetes diagnosis, can lead to vascular problems, kidney disease, and nerve and retinal damage. It is one of the greatest risk factors for the development of diabetes.

A previous study from the university’s College of Public Health and Health Professions had found that very few patients who met the criteria for prediabetes were told by their doctors they had the condition. Less than one quarter of those patients received drug or lifestyle modification treatment.

This new study set out to find out why the detection and treatment of prediabetes is so low when it is known what the guidelines say about diagnosis and treatment and that many millions of Americans have this condition.

‘We know from the literature that there are some different points of view on prediabetes. Some physicians think that a prediabetes diagnosis over medicalises patients and some believe it is best to focus on providing general advice on healthy lifestyle,’ said Arch Mainous, chair of the department of health services research, management and policy.

The American Diabetes Association recommends that all adults who are overweight or obese or over the age of 45 should be screened for prediabetes and the US Preventive Services Task Force recommends prediabetes screening for adults age 40 to 70 who are overweight or obese. Prediabetes treatment plans include drug therapy or intensive lifestyle modification.

The new UF study surveyed more than 1,200 family doctors working in an academic medical setting, asking them to rate the strength of the current evidence for prediabetes screening and treatment, the costs and benefits of formally diagnosing patients with prediabetes and the value in focusing on prediabetes as a way to prevent diabetes.

The researchers found that physicians who have a positive attitude toward prediabetes as a clinical condition were more likely to follow national guidelines for prediabetes screening and to offer treatment for their patients.

Those who hold a negative attitude toward prediabetes were more likely to recommend to their patients general lifestyle changes that may reduce cardiovascular disease risk, but are not associated with lowering blood glucose levels.

‘I’m hoping that we can change physician attitudes so that they follow and trust the screening and treatment guidelines, which are evidence based, and view it as a worthwhile way to prevent diabetes,’ Mainous said.

Another key finding is that regardless of whether they hold a positive or negative attitude toward prediabetes, the majority of physicians surveyed indicated there are several patient barriers to diabetes prevention, including a patient’s economic resources, sustaining patient motivation, a patient’s ability to modify his or her lifestyle and time to educate patients.

‘This suggests we need to provide new resources for physicians to support them in helping patients make lifestyle changes,’ Mainous added.

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Glucose Regulation Helps Prevent Diabetes Development

June 15, 2012 News

Individuals that have been diagnosed with pre-diabetes have a lower risk to develop the disease when their blood glucose levels are normalized in time. This study was conducted by the Colorado School of Public Health and University of Colorado School of Medicine and was published in the journal The Lancet. According to Leigh Perreault MD, […]

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