Observational studyJournal of general internal medicine2021
Treatment of Patients with Prediabetes in a Primary Care Setting 2011-2018: an Observational Study.
Observational study in Journal of general internal medicine, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers.
What it found
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
14 citing papers in PubMed.
- Assessing the implementation of a clinical decision support tool in primary care for diabetes prevention: a qualitative interview study using the Consolidated Framework for Implementation Science.BMC medical informatics and decision making · 2022Trial
- Risk factors associated with prediabetes-to-diabetes conversion in a majority-minority county: a real-world analysis.Journal of diabetes and metabolic disorders · 2026Article
- Applying the ORBIT model to design a patient-facing mHealth app for diabetes prevention in urban primary care: translating patient perspectives into app design.Translational behavioral medicine · 2026Article
- Metformin Prescription Orders among Patients with Prediabetes in a National Network of Federally Qualified Health Centers.Journal of general internal medicine · 2026Article
- Providing diabetes prevention services and navigating care transitions: perspectives from primary care providers.BMC primary care · 2025Article
- Evaluating the metformin use on type 2 diabetes prevention in high-risk populations in primary care.Journal of family medicine and primary care · 2024Article
- A Primary Care-Based Weight Navigation Program.JAMA network open · 2024Article
- Cardiometabolic Risk: Shifting the Paradigm Toward Comprehensive Assessment.JACC. Advances · 2024Article
- Modern-Day Management of the Dysglycemic Continuum: An Expert Viewpoint from the Arabian Gulf.Diabetes, metabolic syndrome and obesity : targets and therapy · 2024Review
- Primary care providers' perspectives on referrals to the Diabetes Prevention Programme: a qualitative comparative study across varied referral patterns.BMJ nutrition, prevention & health · 2024Article
- Preferences and Adherence of People with Prediabetes for Disease Management and Treatment: A Systematic Review.Patient preference and adherence · 2023Review
- Clinical Care Among Individuals with Prediabetes in Primary Care: a Retrospective Cohort Study.Journal of general internal medicine · 2022Article
- A nutritional supplement based on a synbiotic combination ofFrontiers in nutrition · 2022Article
- Patient and Provider Prediabetes Knowledge, Attitudes, and Behaviors in a Large Urban Family Medicine Practice.American journal of lifestyle medicineReview
Corrections and comments
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Authors and funding
6 authors.
Funding
Abstract
backgroundOver one third of American adults are at high risk for developing diabetes, which can be delayed or prevented using interventions such as medical nutrition therapy (MNT) or metformin. Physicians' self-reported rates of prediabetes treatment are improving, but patterns of actual referral, prescription, and MNT visits are unknown.
objectiveTo characterize treatment of prediabetes in primary care.
designWe conducted a retrospective cohort study using electronic health record data. We described patterns of treatment and used multivariable logistic regression to evaluate the association of patient factors and PCP-specific treatment rate with patient treatment. PATIENTS: We included overweight or obese outpatients who had a first prediabetes-range hemoglobin A1c (HbA1c) during 2011-2018 and had primary care provider (PCP) follow-up within a year. MAIN MEASURES: We collected patient characteristics and the following treatments: metformin prescription; referral to MNT, diabetes education, endocrinology, or bariatric medicine; and MNT visit. We did not capture within-visit physician counseling. KEY
resultsOf 16,713 outpatients with prediabetes, 20.4% received treatment, including metformin prescriptions (7.8%) and MNT referrals (11.3%), but only 7.4% of referred patients completed a MNT visit. The strongest predictor of treatment was the patient's PCP's treatment rate. Some PCPs never treated prediabetes, but two treated more than half of their patients; 62% had no patients complete a MNT visit. Being younger or female and having higher body mass index or HbA1c were also positively associated with treatment. Compared to white patients, black patients were more likely to receive MNT referral and less likely to receive metformin.
conclusionsAlmost 80% of patients with new prediabetes never received treatment, and those who did receive referrals had very poor visit completion. Treatment rates appear to reflect provider rather than patient preferences.
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