Survey Reveals Gaps in Provider Knowledge About Prediabetes and Diabetes

A study published in the Journal of General Internal Medicine observed gaps in primary care physicians’ (PCPs) diabetes knowledge and suggested that addressing this may improve the identification and management of people with prediabetes.

A cross-sectional survey was mailed to a nationally representative random sample of U.S. PCPs (n=1,000) who were randomly selected from the American Medical Association’s Physician Masterfile, which houses data on more than 1.4 million physicians, residents, and medical students. Eligible participants included general practitioners who had completed residency training, general internists, and family physicians. Questions assessed PCP knowledge, practice behaviors, and perceptions related to prediabetes.

One-third of eligible participants (33%; n=298) completed the survey. The researchers found that PCPs had limited knowledge on:

  • Risk factors for prediabetes screening
  • Laboratory diagnostic criteria for prediabetes
  • Management recommendations for patients with prediabetes

More than one-third of PCPs (36%) said they refer patients to a diabetes prevention lifestyle change program as their initial management approach, while less than half (43%) discuss the initiation of metformin for those with prediabetes.

On average, respondents correctly selected 10 of 15 risk factors for prediabetes, most often missing that African Americans and Native Americans are at high risk for the disease. In addition, just 8% of respondents knew that a 7% weight loss is the minimum recommended by the American Diabetes Association as part of a diabetes prevention lifestyle change program.

About one-quarter of respondents misidentified patients with diabetes as having prediabetes, which could indicate a delay in getting patients proper care and disease management, according to the researchers.

PCPs said there are perceived barriers to type 2 diabetes prevention at both the individual (e.g., patients’ lack of motivation) and system (e.g., lack of weight loss resources) levels.

The respondents said that increased access to and insurance coverage of type 2 diabetes prevention programs and better referral coordination for these resources would improve type 2 diabetes preventive efforts. Read more