Diabetes Risk Calculator Spurs Prediabetes Action

Miriam E. Tucker, for Medscape

June 30, 2022

Researchers published the study covered in this summary on medRxiv.org as a preprint that has not yet been peer reviewed.

Key Takeaways

  • Adults with prediabetes who received results from a Diabetes Risk Calculator (DRC) and acted on them by accessing a free, preventive intervention were less likely to have prediabetes or diabetes at 1- and 3-year follow-up compared with similar study subjects who received the same information but did not access the preventive intervention.

  • When the electronic health records that the primary care physicians maintained for these people were programmed to automatically complete a DRC for each patient, a significantly larger proportion of these patients received from their physician the recommended interventions for people diagnosed with prediabetes.

  • The DRC seems to provide an effective way for clinicians to communicate with people with prediabetes and to promote interventions aimed at preventing obesity and diabetes.

Why This Matters

  • One in three US adults has prediabetes, but 90% of these people are unaware of their status.

  • Strategies exist that are proven to prevent or delay diabetes, particularly via weight loss.

  • Broader and more routine use of the DRC in US primary care practice may advance efforts to achieve existing national goals for reducing the incidence of diabetes. Wider DRC use may also make patients more likely to engage with and clinicians more likely to prescribe interventions that can delay progression to diabetes.

Study Design

  • Single-arm study of 328 "eligible" people identified during 2018-2022 at three primary care sites in the Geisinger Health System of central Pennsylvania.

  • Of the 328 eligible people, 81 responded to initial contact, including 62 diagnosed with prediabetes who formed the "treatment" group; 55 of those people provided 1- and 3-year follow-up data. The remaining 247 nonresponders served as controls, with 169 providing 1- and 3-year follow-up data.

Key Results

  • At 1-year follow-up in the treatment group, 11% had resolved prediabetes, 87% still had prediabetes, and 2% progressed to type 2 diabetes, compared with 1-year prevalence rates of 2%, 79%, and 20%, respectively, among the nonresponders. These between-group differences were significant.

  • At 3 years, the prevalence rates for these three outcomes in the treatment group were 11%, 64%, and 25%, respectively, compared with 5%, 53%, and 42% among the nonresponders, again significant between-group differences.

  • In the pre-implementation phase for the DRC, 9268 patients met the criteria for assessment by the DRC, of whom 0.3% received an anti-obesity medication and 9.7% received referral to a preventive intervention.

  • The subsequent early-implementation phase (first 6 months) of automatic patient assessment using the DRC included 8771 patients, of whom 0.4% received an anti-obesity medication and 10.7% received referral to a preventive intervention.

  • Compared with the pre-implementation phase, a significantly higher proportion of patients received either a referral or an anti-obesity medication during the early implementation phase.

Limitations

  • The authors did not identify the limitations of their study.

Disclosures

  • The study received funding from the Geisinger Health Plan Quality Fund Pilot Project Program.

  • All the authors are Geisinger employees. They had no other disclosures.

This is a summary of a preprint research study, "Communicating risk of diabetes to patients results in lower incidence at 1- and 3-year follow-up and improved preventive intervention," written by researchers at Geisinger Health in Danville, Pennsylvania on medRxiv, and provided to you by Medscape. The study has not yet been peer reviewed. The full text of the study can be found on medRxiv.org.

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