How to prevent diabetes from sneaking up on your patients

Stephen R. Permut, MD, JD
Immediate Past Board Chair
American Medical Association
Email this page

A major health threat has been silently taking hold of 86 million Americans, with 90 percent of them unaware of it. A new public health campaign is about to change that—and you’re the key to helping these patients take their health back.

A campaign to prevent type 2 diabetes

If you’re not already talking to your patients about prediabetes and the risks associated with it, it’s time to start. People with prediabetes—more than 1 in 3 adults—are at higher risk of developing serious health problems such as type 2 diabetes, heart disease and stroke. But the earlier patients know that they have prediabetes and start taking steps to address it, the better their chances of preventing type 2 diabetes and associated complications.

That’s why the AMA has partnered with the Centers for Disease Control and Prevention (CDC), the American Diabetes Association and the Ad Council in a highly visible public service ad campaign that clearly delivers an important message: Everyone needs to know whether they have prediabetes or not.

The campaign is just getting underway today, and people will begin encountering these ads on their daily commutes, as they watch their favorite TV programs, listen to the radio and go online. Using humor, the ads get people’s attention that there’s no excuse not to find out their prediabetes risk, which they can do through a simple risk assessment at DoIHavePrediabetes.org.

What you need to know (before your patients start asking)

You’ll probably start getting questions from your patients who have encountered the ads and may even have taken the online risk assessment. Here are key points to remember:

  • Prediabetes. This is a condition in which blood glucose levels are higher than normal but not high enough to be diagnosed as diabetes.
     
  • Prevalence. More than one-third of the U.S. adult population has prediabetes. Prediabetes is more common in older individuals, affecting more than 50 percent of people older than 65 years.
     
  • Disease risk. People with prediabetes are at high risk of developing type 2 diabetes: As many as 70 percent of people with prediabetes could develop type 2 diabetes during their lifetime. They also have a 20 percent increased risk of developing cardiovascular disease compared to individuals with normal glucose metabolism.
     
  • Prevention. A diagnosis of prediabetes doesn’t mean that a patient is destined to develop type 2 diabetes. Taking steps such as losing weight and increasing physical activity can completely prevent or at least delay the onset of type 2 diabetes.

One of the best, evidence-based ways to reduce diabetes risk is to participate in a CDC-recognized diabetes prevention program. Such programs emphasize healthy eating and increased physical activity, and they can reduce the risk of developing diabetes by more than one-half.

What you can do

You may have patients in the coming weeks and months who have seen the new ads and are anxious to talk about prediabetes. Even if they haven’t seen the ads, your patients need to hear from you about this health condition. What do you need to do, and how do you incorporate new steps into your busy practice?

There’s an easy way to remember, and it comes with practical resources for your practice: Prevent Diabetes STAT: Screen, Test, Act—Today™. This joint initiative of the AMA and the CDC outlines three important steps:

  • Screen patients for prediabetes using the CDC Prediabetes Screening Test or the American Diabetes Association Diabetes Risk Test
  • Test for prediabetes using one of three blood tests
  • Act by referring patients with prediabetes to a nearby diabetes prevention program

As a family physician, I know that adding one more thing to an already heavy workload can be an overwhelming prospect. But this initiative provides the resources you need to easily incorporate these steps into your practice.

Depending on what makes the most sense for your practice, there are two different options for how your practice team can identify patients with prediabetes and refer them to the prevention program they need. Members of your practice team can either screen and test patients at the point of care, or they can do so retrospectively by generating a registry of at-risk patients via your electronic health record system.

The Prevent Diabetes STAT toolkit offers everything you need for either approach, including:

  • Patient handouts
  • Risk assessments
  • Prediabetes identification algorithm and patient flow process for engaging patients at the point of care
  • Retrospective diabetes identification algorithm
  • Sample patient letters and phone scripts

If you want to learn even more about prediabetes and what you can do, the AMA provides a free module in its STEPS Forward™ collection that is approved for AMA PRA Category 1 Credit ™. We also offer a more extensive performance improvement continuing medical education activity that is also approved by the American Board of Family Medicine for Maintenance of Certification for Family Physicians Part IV credit.

Why we need to act now

Having practiced family medicine in the inner city for decades, I’m all too familiar with the devastating effects diabetes can have on patients and their families. No doubt you’ve seen these effects among your patients too.

Without taking action now to address prediabetes, it’s estimated that the typical primary care physician could see up to a 50 percent increase in type 2 diabetes among his or her patients over the next five years. That’s a trend we can and must stop—and to do so, we must act now.

Let’s address prediabetes today to make sure our patients have a healthier tomorrow.

Email this page

Comments

This is all well and good, but how does an uninsured patient access a diabetes prevention program? I read the entire tool kit. Problem is not who to screen--problem is access to an educator.
Show Comments (1)
Dr. Celeste Philip
Nov 29, 2016
The Sunshine State’s surgeon general offers insights on difficult choices faced amid local spread of the mosquito-borne illness.