Li Erica, Waters Alexa, Cunningham Amy, Silverio Alexis, Han Jasmine, Mills Geoffrey
Department of Family and Community Medicine, Thomas Jefferson University, Philadelphia, PA, USA (EL, AW, AC, AS, GM); and Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA (JH).
Am J Lifestyle Med. 2022 Sep 28;18(6):727-736. doi: 10.1177/15598276221123527. eCollection 2024 Nov-Dec.
One-third of U.S. adults have prediabetes, but only 11% are aware of their condition. Many do not receive education or treatment. The purpose of this study is to understand family medicine providers' and patients' attitudes, knowledge, and behaviors regarding prediabetes and its management, to guide future management interventions. Cross-sectional surveys of providers ( = 54, 57% response rate) and patients with prediabetes ( = 148, 16.5% response rate) were administered at a large urban academic family medicine practice. Nearly all providers agree prediabetes screening is important, but over half were unaware of the national Diabetes Prevention Program (DPP) and most do not prescribe metformin to eligible patients. Over half of patients reported being told they have prediabetes but <5% had been referred to DPP and over half were unaware of medication options. In open-ended responses, providers suggested nutrition counseling resources and an improved DPP referral process to improve prediabetes care. Patients requested clear diagnosis, education on treatment options, and nutritional counseling. This study indicates that notable gaps continue to exist in provider and patient understanding and management of prediabetes, suggesting that interventions to improve prediabetes care should include more effective counseling on diagnosis and treatment and expanding access to nutrition and educational resources.
三分之一的美国成年人患有糖尿病前期，但只有11%的人意识到自己的病情。许多人没有接受教育或治疗。本研究的目的是了解家庭医生和患者对糖尿病前期及其管理的态度、知识和行为，以指导未来的管理干预措施。在一家大型城市学术性家庭医疗诊所对医生（n = 54，回复率57%）和糖尿病前期患者（n = 148，回复率16.5%）进行了横断面调查。几乎所有医生都认为糖尿病前期筛查很重要，但超过一半的人不知道国家糖尿病预防计划（DPP），而且大多数医生不会给符合条件的患者开二甲双胍。超过一半的患者报告说他们被告知患有糖尿病前期，但不到5%的人被转诊到DPP，超过一半的人不知道有哪些药物选择。在开放式回答中，医生建议提供营养咨询资源并改进DPP转诊流程，以改善糖尿病前期护理。患者要求明确诊断、提供治疗选择方面的教育以及营养咨询。这项研究表明，医生和患者在糖尿病前期的理解和管理方面仍然存在明显差距，这表明改善糖尿病前期护理的干预措施应包括在诊断和治疗方面提供更有效的咨询，并扩大营养和教育资源的获取渠道。
