Background
Methods
Statistical analysis
Results
Provider characteristics | N (%) |
---|---|
Specialty | |
General medicine | 189 (60.2) |
Specialty medicine | 107 (34.1) |
Internal medicine | 87 |
Family medicine | 11 |
Other specialties | 9 |
Others | 18 (5.7) |
Provider type | |
Physicians | 296 (94.3) |
Nurse | 12 (3.8) |
Nutritionist | 5 (1.6) |
Physical conditioner | 1 (0.3) |
Number of years since completing traininga | |
< 5 years | 112 (42.4) |
5–10 years | 41 (15.5) |
10+ years | 111 (42.1) |
Gender | |
Female | 174 (53.7) |
Male | 150 (46.3) |
Knowledge of risk factors and laboratory criteria, prediabetes practice and management
N (%) | P value | |
---|---|---|
Correct identification of diabetes laboratory criteria; fasting glucose | 275 (83.3) | 0.001 |
Correct identification of diabetes laboratory criteria; HbA1c | 192 (58.2) | 0.055 |
Correct identification of prediabetes laboratory criteria; fasting glucose | 168 (48.2) | 0.349 |
Correct identification of prediabetes laboratory criteria; HbA1c | 49 (15.1) | 0.481 |
Correct body weight loss recommendation; 5–7% | 107 (35.1) | 0.172 |
Correct physical activity recommendation; 150 min/week | 167 (51.7) | 0.391 |
Correct initial management recommendation; referral to behavioral weight loss program | 7 (3.03) | 0.519 |
Practice | N (%) current study | P value |
---|---|---|
Initial management approach | ||
Counseling on diet changes and physical activity | 313 (94.9) | 0.063 |
Refer to nutritionist | 189 (57.3) | 0.002 |
Refer to behavioral weight loss program | 98 (29.7) | 0.132 |
Discuss starting metformin | 102 (30.9) | 0.832 |
Refer for bariatric surgery | 10 (3.0) | 0.934 |
Repeat laboratory tests | ||
3 months | 233 (70.8) | < 0.001 |
6 months | 62 (18.8) | 0.001 |
1 year | 23 (7.0) | 0.754 |
2 years | 2 (0.6) | – |
No specific recommendation | 9 (2.8) | 0.900 |
Return for follow-up clinic visit | ||
3 months | 247 (75.1) | < 0.001 |
6 months | 45 (13.7) | 0.004 |
1 year | 16 (4.9) | 0.992 |
2 years | 1 (0.3) | – |
No specific recommendation | 1 (0.3) | – |
% Patients with prediabetes prescribed metformin | ||
0% | 72 (21.9) | 0.766 |
1–5% | 93 (28.3) | 0.343 |
> 5–25% | 76 (23.1) | 0.746 |
> 25–50% | 41 (12.5) | 0.586 |
> 50–75% | 29 (8.8) | 0.784 |
> 75% | 18 (5.5) | 0.809 |
Attitudes, beliefs and barriers
N (%) | P value | |
---|---|---|
Barriers to lifestyle modification (strongly agree and agree) | ||
Patient’s lack of motivation | 290 (88.4) | 0.488 |
Patient’s physical limitation in doing activity | 200 (61.7) | 0.040 |
Lack of weight loss resources for patient | 148 (45.3) | 0.003 |
Lack nutrition resources for patient | 176 (53.7) | 0.006 |
Patients do not think it is important to make these changes | 235 (72.5) | 0.404 |
Financial limitations | 161 (49.2) | 0.346 |
Barriers to metformin use (strongly agree and agree) | ||
Patients dislike taking medications | 228 (70.8) | 0.001 |
Medication cost to patient | 108 (33.4) | 0.188 |
Poor patient adherence | 246 (76.2) | 0.232 |
Potential side effects | 188 (58.6) | 0.001 |
Providers’ lack of awareness of clinical guidelines for metformin use | 197 (61.4) | 0.270 |
Lack of FDA approval for metformin use in prediabetes | 97 (30.8) | 0.878 |
Interventions to improve management of prediabetes (strongly agree and agree) | ||
More time for doctors to counsel patients | 275 (83.8) | 0.768 |
More educational resources for patients | 291 (88.7) | 0.816 |
Improved access to diabetes preventive programs | 302 (92.4) | 0.199 |
Improved nutrition resources for patients | 278 (84.8) | 0.006 |
Improved access to weight loss programs | 282 (86.5) | 0.229 |
Improved access to bariatric surgery | 103 (31.6) | 0.613 |