Identifying prediabetes in primary care
Date
2020
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Publisher
University of Delaware
Abstract
Background: Type 2 diabetes is a significant, chronic health problem in the state of Maryland and nationally. Screening and identification of its’ precursor, prediabetes, has the potential to prevent or delay onset of type 2 diabetes. Currently more than one third of the US population meets criteria for prediabetes, and 90 % are unaware of their condition. The USPSTF and ADA have published conflicting guidelines with regard to screening for prediabetes, thus leading to provider confusion and decreased screening rates. ☐ Purpose: The purpose of this project was to identify a single, superior guideline for prediabetes screening, in order to improve identification and, potentially, prevent or delay onset of type 2 diabetes in the future. ☐ Theoretical Framework: This project was implemented utilizing the Diffusion of Innovations Theory, in which an innovation is evaluated for adoption or rejection based upon specific components and applicability to the implementation setting. ☐ Methods: Data were collected weekly through patient self-surveys of ADA-identified risk factors, provider interviews and Hemoglobin A1C laboratory studies. Positive results were evaluated to determine if they would have met criteria for screening using USPSTF and ADA guidelines. ☐ Results: Of the 561 individuals screened, 72 met criteria for screening and 68 completed the required laboratory studies. Of those individuals, 34 results, 50%, were identified as prediabetes and four results were identified as diabetes. Of those results 18, 52.9%, of those identified as prediabetes met ADA criteria but not USPSTF criteria, and one, 2.9%, of those identified as diabetes met ADA criteria but not USPSTF criteria. In the evaluation of risk factors, first degree family history of type two diabetes was the most prevalent. It was present in 76.5% of positives. ☐ Conclusion and Implications: Utilizing the ADA guidelines for prediabetes screening identifies more positive results and has the potential to improve health outcomes for individuals at risk for developing type 2 diabetes. First degree family history of type 2 diabetes was the risk factor present most in positive results. No significant barriers to implementation were identified. ☐ Keywords: Screening Guidelines, ADA, USPSTF, prediabetes, risk factors
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Keywords
Prediabetes, Risk Factors, Screening