Family medicine

Chances are your doctor wouldn’t either, according to the results of a new national survey of primary care physicians (PCPs) conducted by Johns Hopkins Medicine researchers. In a report on their findings in the Journal of General Internal Medicine (JGIM); the researchers say their survey of 1,000 randomly selected PCPs revealed significant gaps in the group’s overall knowledge of risk factors; diagnostic criteria and recommended management/prevention practices for prediabetes.

Primary care physicians

The researchers also say the gaps may result from a health care education and reimbursement system that encourages doctors to prioritize treating diabetes once the disease occurs rather than working with patients to prevent it. Therefore “Our survey findings suggest that these gaps contribute to doctors underscreening for and missing diagnoses of prediabetes; and in turn, not referring patients to type 2 diabetes prevention programs;” says Eva Tseng, M.D., M.P.H., an assistant professor of general internal medicine at the Johns Hopkins University School of Medicine and lead author of the JGIM paper.

“Along with closing the PCP knowledge gaps our survey identified; we believe the problem needs to be addressed at the health care system level;” says Nisa Maruthur, M.D., M.H.S., a Johns Hopkins associate professor of medicine and a co-author of the JGIM paper. But “This includes concerted efforts to make both health care providers ;and patients more aware of available type 2 diabetes prevention programs; encouraging patient enrollment in these programs, and getting insurance companies to understand their value and cover the costs.”

Weight loss and regular exercise

According to the U.S. Centers for Disease Control and Prevention; prediabetes is a serious health condition in which blood sugar levels are higher than normal, but not high enough to meet the threshold for type 2 diabetes. The federal agency says that some 84 million Americans ages 18 or older more than one out of three have prediabetes but 90% don’t know it. If diagnosed early; experts say; lifestyle changes such as weight loss and regular exercise can prevent or delay the development of type 2 diabetes and the increased risks it poses for heart disease; stroke, kidney failure and nerve damage.

For their new study; the Johns Hopkins researchers sent surveys to 1,000 PCPs randomly selected from the American Medical Association’s Physician Masterfile which includes data on more than 1.4 million physicians; residents and medical students in the United States. Because Candidates for the survey included general practitioners who had completed residency training, general internists and family physicians. Therefore Survey questions evaluated a physician’s knowledge of (1) risk factors that should prompt prediabetes screening; laboratory criteria for diagnosing prediabetes; and recommendations for prediabetes management, (2) practice behaviors regarding prediabetes management and (3); perceived barriers and potential interventions to improve prediabetes management.