Department of Health Services Research, Management & Policy, College of Public Health and Health Professions, University of Florida, Gainesville, Florida; UF Community Health & Family Medicine, College of Medicine, University of Florida, Gainesville, Florida.
UF Community Health & Family Medicine, College of Medicine, University of Florida, Gainesville, Florida.
Am J Prev Med. 2022 Jan;62(1):50-56. doi: 10.1016/j.amepre.2021.06.018. Epub 2021 Nov 1.
Type 2 diabetes is a widespread, preventable illness. The U.S. Preventive Services Task Force (USPSTF) has screening guidelines for diabetes prevention. The aim is to establish the extent to which U.S. Preventive Services Task Force's guidelines for prediabetes screening, diagnosis, and treatment are followed in a large health system and to identify missed opportunities for diabetes prevention.
A comprehensive analysis of the electronic health records for the entire patient population of a large health center between August 1, 2019 and October 31, 2020 was analyzed, focusing on 21,448 patients eligible for prediabetes screening according to USPSTF recommendations. Compliance with U.S. Preventive Services Task Force recommendations for screening, diagnosis, and treatment was assessed.
Of the 21,448 patients identified as eligible for prediabetes screening, 13,465 (62.8%) were screened in accordance with the USPSTF recommendations. Of those patients screened, 3,430 met the requirements for a prediabetes diagnosis. Only 185 (5.4%) of patients who screened positive for prediabetes received a formal diagnosis of prediabetes, and no patients who received a diagnosis received appropriate treatment for their prediabetes. Women were more likely than men to be screened (p<0.001), and non-Hispanic Whites were less likely than non-Hispanic Blacks and Hispanics to be formally diagnosed even after screening positive (p<0.001).
Although a majority of eligible patients receive appropriate screening for prediabetes, diagnosis and treatment of patients who screen positive for prediabetes is not common practice. Future research and policy may benefit from a focus on classifying diabetes prevention as a quality metric and incentivizing behaviors consistent with diabetes prevention.
2 型糖尿病是一种广泛存在且可预防的疾病。美国预防服务工作组（USPSTF）有预防糖尿病的筛查指南。其目的是确定在一个大型医疗系统中，美国预防服务工作组关于糖尿病前期筛查、诊断和治疗的指南的遵循程度，并确定预防糖尿病的机会是否被错失。
对 2019 年 8 月 1 日至 2020 年 10 月 31 日期间一个大型医疗中心的全体患者的电子健康记录进行了全面分析，重点关注根据 USPSTF 建议有资格进行糖尿病前期筛查的 21448 名患者。评估了筛查、诊断和治疗是否符合美国预防服务工作组的建议。
在确定的 21448 名有资格进行糖尿病前期筛查的患者中，有 13465 名（62.8%）按照 USPSTF 的建议进行了筛查。在接受筛查的患者中，有 3430 名符合糖尿病前期诊断要求。仅有 185 名（5.4%）糖尿病前期筛查阳性的患者接受了糖尿病前期的正式诊断，且没有患者接受了适当的糖尿病前期治疗。女性接受筛查的可能性大于男性（p<0.001），即使在筛查阳性后，非西班牙裔白人被正式诊断为糖尿病前期的可能性也小于非西班牙裔黑人和西班牙裔（p<0.001）。
尽管大多数符合条件的患者接受了适当的糖尿病前期筛查，但对糖尿病前期筛查阳性患者的诊断和治疗并非常见做法。未来的研究和政策可能受益于将糖尿病预防分类为质量指标，并激励与预防糖尿病一致的行为。
