Claims Analysis Suggests High Annual Diabetes Screening Rates in US Prediabetes Care

Most US patients with prediabetes appear to be receiving recommended annual diabetes screening, according to a company-sponsored analysis of more than 100 million insurance claims released by Motive Medical Intelligence. The report estimated a national screening underuse rate of 8%, defined as the proportion of patients with prediabetes who should have been screened for diabetes but were not, according to the company press release.¹

“This is welcome news,” Rich Klasco, MD, chief medical officer at Motive, said in the release. “The data show that most clinicians are providing high-quality care for their patients with prediabetes.” He added that the observed state-to-state variation suggests “nearly perfect adherence is attainable within our current clinical and reimbursement structures.”¹

For clinicians, the finding is relevant because prediabetes is common, often unrecognized, and associated with progression to type 2 diabetes and downstream microvascular and cardiovascular complications. In the US, an estimated 38% of adults have prediabetes, and most are unaware of it.² Annual reassessment for progression to diabetes is consistent with current American Diabetes Association recommendations for people with prediabetes.³

The Motive analysis has not been published in a peer-reviewed journal, and details on cohort selection, coding definitions, payer mix, and statistical methods were not included in the press release.¹ Those limitations make it difficult to independently evaluate the validity of the estimates or compare them directly with other quality-of-care datasets. Still, the release offers a large-scale claims-based snapshot suggesting relatively high uptake of follow-up diabetes testing among already identified at-risk patients.

According to the company, the best-performing states were Nebraska, South Dakota, and Minnesota, each with an underuse rate of 3%. Delaware, Rhode Island, and New York had underuse rates of 18%, 16%, and 14%, respectively.¹ The reasons for those differences were not reported. Potential contributors could include differences in coding practices, insurance coverage, patient follow-up, access to primary care, and health system quality infrastructure, although the release did not examine these factors.

The broader clinical context is well established. Prediabetes affects a substantial share of the adult population and carries elevated risk for progression to diabetes, but progression is not inevitable. The Diabetes Prevention Program showed that intensive lifestyle intervention and metformin can reduce incident diabetes in high-risk adults, with lifestyle intervention producing the largest effect.⁴ That trial supports the rationale for identifying and monitoring people with dysglycemia before overt diabetes develops.

Guidance differs somewhat depending on the screening question being asked. The US Preventive Services Task Force recommends screening for prediabetes and type 2 diabetes in adults aged 35 to 70 years with overweight or obesity and offering or referring those with prediabetes to effective preventive interventions.⁵ The ADA separately recommends that people with prediabetes be tested yearly for development of diabetes.³ The Motive analysis addresses the latter issue—follow-up surveillance among patients already identified as having prediabetes—rather than initial population screening.

The report also arrives amid growing concern about the economic burden of diabetes. A recent American Diabetes Association analysis estimated total US diabetes-related costs at $412.9 billion in 2022, including both direct medical costs and reduced productivity.⁶ If annual reassessment in prediabetes leads to earlier diagnosis and better implementation of preventive interventions, that could be clinically meaningful. However, claims-based measures of testing alone do not show whether abnormal results were acted on, whether patients received structured lifestyle treatment, or whether screening reduced diabetes-related complications.

Next steps would include peer-reviewed publication of the methods and subgroup analyses by age, race and ethnicity, insurance type, and care setting. More granular data could help determine whether high-performing states are using workflows that are transferable to other settings. For now, the report suggests that annual diabetes screening in prediabetes may be more consistently implemented than some clinicians might expect, while also highlighting persistent geographic variation in care delivery.¹

References

1. Motive Medical Intelligence. New national study finds most Americans at risk for diabetes are receiving the recommended screening. PR Newswire. May 13, 2026. Accessed May 14, 2026. https://www.prnewswire.com/news-releases/new-national-study-finds-most-americans-at-risk-for-diabetes-are-receiving-the-recommended-screening-302770244.html
2. Fang M, Wang D, Coresh J, Selvin E. Trends in diabetes treatment and control in US adults, 1999-2018. Published data cited in press release reporting that 38% of US adults have prediabetes and that many are unaware. JAMA. 2021;326(8):704-716.
3. American Diabetes Association Professional Practice Committee. 2. Diagnosis and classification of diabetes: Standards of Care in Diabetes—2024. Diabetes Care. 2024;47(suppl 1):S20-S42.
4. Knowler WC, Barrett-Connor E, Fowler SE, et al; Diabetes Prevention Program Research Group. Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N Engl J Med. 2002;346(6):393-403.