Among medicine’s missed opportunities, diabetes prevention nears the top
Type 2 diabetes has reached epidemic status in the United States, but you may not know it from the reaction of the medical profession. A recent study shows that although the US Preventive Services Task Force (USPSTF) made simple recommendations for screening for prediabetes, less than two-thirds of patients are screened during their primary care visits, and very few are diagnosed or diagnosed. processing.
For the study, “Preventing Diabetes in a U.S. Health Care System: A Snapshot of Missed Opportunities, “Posted in American Journal of Preventive Medicine, the researchers looked at the records of more than 21,000 patients eligible for prediabetes screening in a large Florida healthcare system. They found that 62.8% were screened according to USPSTF recommendations. Of these, a quarter fully met the requirements for a diagnosis of prediabetes, but only about 5% of them received one. And no one – not a single patient – who has been diagnosed has received proper treatment.
“Am I surprised? Unfortunately, no, ”said study lead author Arch G. Mainous III, PhD, professor in the Department of Health Services Research, Management and Policy at the University of Florida. “When we look at these epidemiological studies at the population level, we find that 80 to 90% of people with prediabetes go undiagnosed. So we already know that people are not screened.
But Mainous and his co-authors did not examine the population level. They looked at a group that was already in a health care system.
“Readers might think these patients don’t have access to care, but they are all active patients,” Mainous said.
Learn about system-level best practices for preventing diabetes.
“If you don’t give a patient a diagnosis, they won’t change their behavior,” Mainous said. “Without any treatment, I don’t know how we could expect anything to change.”
Everything points to a discrepancy between the philosophy of the profession and the structure of the health system. On the one hand, the mission of medicine is to keep people healthy, to prevent suffering. But in the current payment system, prevention is just not the top priority.
“We have guidelines for prevention, but we don’t encourage them,” Mainous said.
Most of the health care system in the United States does not promote quality care until people have been diagnosed with type 2 diabetes.
“It plays a huge role,” Mainous added. “If you look at other guidelines, the ones that are encouraged, you will likely see much higher compliance with them. “
This failure to encourage prevention is rapidly adding to type 2 diabetes, costing the United States more than $ 300 billion a year.
AMAs Diabetes Prevention Guide supports physicians and healthcare organizations in defining and implementing evidence-based diabetes prevention strategies. This comprehensive, personalized approach helps clinical practices and healthcare organizations identify patients with prediabetes and manage the risk of developing type 2 diabetes, including referring at-risk patients to a mode-switching program. of the National Diabetes Prevention Program according to their individual needs.
Find out three things that can help doctors improve diabetes prevention.