In a survey of US primary care physicians (PCPs), less than half (42%) of respondents chose the correct values of key laboratory tests that would identify prediabetes. Only 8% knew that a 7% weight loss is the minimum recommended by the American Diabetes Association as part of a lifestyle-change approach to prevent progression to type 2 diabetes mellitus (T2DM). A number of other significant gaps in knowledge and practice were also uncovered.
The survey of 1000 US PCPs was conducted by researchers at Johns Hopkins Medicine (JHM) and the results published online September 9 in the Journal of General Internal Medicine. The survey assessed PCP knowledge, practice behaviors, and perceptions related to prediabetes and is believed to be the first national survey to evaluate PCP knowledge and practices related to the precursor to T2DM.
"Our survey findings suggest that these gaps contribute to doctors underscreening for and missing diagnoses of prediabetes," Eva Tseng, MD, MPH, assistant professor of general internal medicine at the Johns Hopkins University School of Medicine and lead study author said in a JHM press release. When the diagnosis is not made, Dr Tseng continued, patients are not referred to diabetes prevention programs.
Moreover, according to Johns Hopkins associate professor of medicine and a co-author of the JGIM paper Nisa Maruthur, MD, MHS “Our results also suggest that 25% of PCPs may be identifying people as having prediabetes when they actually have diabetes, which could lead to delays in getting those patients proper diabetes care and management."
Given the rapid pace of US efforts to prevent T2DM, the authors stress that understanding how prediabetes is managed in primary care is critical.
In total, 298 (33%) eligible participants returned the survey.