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.
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.
Purpose:
Many patients are unknowingly living with chronic hyperglycemia, possibly due to low screening rates. We aimed to correlate detection of unidentified chronic hyperglycemia to practitioner reported rationale for conducting diabetes screening.
Methods:
Physicians screened patients via a point-of-care A1C tests and recorded corresponding rationales. Elevated outcomes (A1C ≥ 5.7%) were correlated to recorded rationales, frequency of repeat screenings, documented diagnoses, and therapeutic actions taken as a result of elevated A1C.
Results:
Nearly one-half (45%) of selected patients were unknowingly living with chronic hyperglycemia, having an average A1C of 7.92% for outcomes ≥6.5%. Most commonly recorded rationales were overweight status (71%), high-risk ethnicity (58%), and age > 45 years (48%); previously recorded A1C result of ≥5.7% (χ2 16.02, p < 0.001) and hypertension diagnosis (χ2 10.37, p = 0.0013) showed statistically significant correlation with elevated A1C outcomes. A1C results ≥6.5% versus 5.7-6.5% more frequently prompted repeat screenings (77% vs 20%), ICD-10 code documentation (91% vs 28%), lifestyle modification recommendations (78% vs 35%), and drug therapy initiation (78% vs 9%).
Conclusions:
Reported rationales were largely impacted by visual inspections of age, race, and weight, and prediabetic A1C values garnered less attention compared to higher values. Utilization of POC A1C screening followed by conformational repeat testing is a practical approach to improve diagnostic rates and initiation of care for diabetes.
Related Concept Videos
Gene Families
Occasionally these regions can be adapted to take on new roles within the organism, becoming novel genes...
Gene Families
Protein Families
Protein Families
Patient-centered Care
Chronic Pancreatitis II: Collaborative Care
Assessment:


