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Rationale of family medicine physicians in effectively identifying patients with chronic hyperglycemia through

Heather P Whitley1,2, Courtney Hanson3, Jason M Parton4

  • 11Department of Pharmacy Practice, Auburn University Harrison School of Pharmacy, Auburn, AL USA.

Journal of Diabetes and Metabolic Disorders
|July 6, 2019
PubMed

Insights

Nearly half of patients screened unknowingly have chronic hyperglycemia. Practitioner rationales for screening, like age and weight, influenced detection, but prediabetes A1C values were often overlooked. Point-of-care A1C testing improves diagnosis and care initiation.

Area of Science:

  • Endocrinology
  • Preventive Medicine
  • Clinical Diagnostics

Background:

  • Chronic hyperglycemia affects many patients, often undiagnosed due to low screening rates.
  • Effective screening strategies are crucial for early detection and management of diabetes.

Purpose of the Study:

  • To correlate the detection of unidentified chronic hyperglycemia with practitioner-reported rationales for diabetes screening.
  • To assess the impact of screening rationales on identifying undiagnosed hyperglycemia.

Main Methods:

  • Physicians utilized point-of-care A1C tests for patient screening.
  • Collected data included practitioner rationales, A1C outcomes (≥5.7%), repeat screening frequency, diagnoses, and therapeutic actions.
  • Statistical analysis correlated elevated A1C outcomes with recorded rationales and subsequent clinical actions.

Main Results:

  • 45% of screened patients were unknowingly living with chronic hyperglycemia (average A1C 7.92% for ≥6.5%).
  • Common rationales included overweight status (71%), high-risk ethnicity (58%), and age >45 (48%).
  • Previously recorded A1C ≥5.7% and hypertension diagnosis significantly correlated with elevated A1C outcomes (p<0.0013).
  • Higher A1C levels (≥6.5%) more frequently led to repeat screenings, documentation, lifestyle recommendations, and drug therapy initiation compared to A1C 5.7-6.5%.

Conclusions:

  • Practitioner screening rationales were primarily influenced by patient demographics (age, race, weight), with prediabetic A1C values receiving less attention.
  • Point-of-care A1C screening followed by confirmatory testing is a practical method to enhance diabetes diagnosis rates and expedite care initiation.
Abstract

Keywords:
A1CDiabetesPoint-of-carePrediabetesPreventionScreening

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