Addressing gaps in pre-diabetes care: health professionals' knowledge, attitudes, and counseling practices

Prediabetes is a global concern and is associated with increased morbidity and mortality. Early detection of prediabetes plays a crucial role since it is a reversible disease. Healthcare providers play a very important role in screening at-risk patients and implementing preventive measures early. This study aimed to assess healthcare professionals' knowledge, attitude and counseling practices regarding prediabetes which will serve as a tool to create targeted training in the future.

We conducted a cross-sectional study on 312 general practitioners and junior doctors. A structured questionnaire designed after detailed literature search was used to collect data on knowledge (23 questions), attitudes (6 questions) and counseling practices (8 questions) regarding prediabetes. The relationship between a range of factors with knowledge, attitude and counseling practices was studied using univariate and multivariate analyses.

Of total, 71.5% (223) of the study participants were males; the average age was 42.7 ± 15.1 years; Only 13.1% had adequate knowledge, 19.9% showed a positive attitude and 77.6% had good counseling practices for prediabetes and diabetes patients and their families. Compared to those with inadequate knowledge, participants with adequate knowledge had been practicing medicine for less than 10 years. Positive attitude and good counseling were however observed more in those with 20 or more years of clinical experience. Females were less likely to have adequate knowledge when compared to males (OR = 0.2, 95% CI 0.1-0.6, p-value = 0.004). A positive attitude toward prediabetes management was significantly higher among participants older than 40 years (OR = 18.6, p-value < 0.001), females (OR = 6.7, p-value < 0.001), and those with over 20 years of clinical experience (OR = 6.3, p-value = 0.014) in managing prediabetes/diabetes patients compared to their counterparts. Additionally, participants with more than 20 years of experience in managing diabetes patients were significantly more likely to exhibit good counseling behavior (OR = 9.1, 95% CI: 1.5-51.7, p = 0.013) compared to those with less than 10 years of experience.

This study identified significant gaps of knowledge among general practitioners. While general practitioners demonstrated poor attitudes, they exhibited commendable counseling practices toward patients with prediabetes and their families. The identified gaps and challenges stress the need for tailored educational initiatives and intervention but also targeted efforts to address attitudes alongside enhancing clinical skills. Limitations of the study, including the potential sampling biases and development of a new, non-validated questionnaire, should be considered when interpreting the results.