Screening and Lifestyle Modification as Management of Prediabetes
Amy Gonzales, MD, Gregory Gallik, DO, Barry Coutinho, MD, Alan Finkelstein, MD and Alyssa Brindle
Introduction:
According to the CDC (2014), 29.1 million Americans have diabetes, and 86 million Americans have prediabetes. Prediabetes is a condition where the blood sugar level is higher than normal, but not high enough for a diagnosis of diabetes. Complications of diabetes include retinopathy, neuropathy, nephropathy and cardiovascular disease. Delaying onset of diabetes by identifying and managing people at risk is important.
Objectives:
The goals of this project are to present diabetes screening guidelines, identify prediabetic patients at the Shadyside Family Health Center and provide them information regarding prevention of overt diabetes and the need for ongoing monitoring.
Method:
From July 2014 to July 2016, 210 patients were identified as prediabetic. The Diabetes Group telephoned each of these patients and encouraged physical activity, diet and weight loss to each patient they reached. Patients were reminded to come back for A1c recheck. Faculty members and residents were also encouraged to screen and talk to patients about prediabetes.
Results:
A total of 46 of the 64 patients that were provided counseling over the phone returned and had their A1c rechecked. Phone messages were left for 74 patients. Ten patients were already diagnosed with diabetes by the time of the phone calls. Three were not interested, and the rest were either deceased, changed PCP, younger than 18 or older than 80.
Conclusion:
Educating providers to identify the at-risk population and providing telephone intervention can be helpful strategies in preventing diabetes.