Prediabetes Diagnosis and Treatment in Primary Care
Prediabetes Diagnosis and Treatment in Primary Care
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DOI：
10.3122/jabfm.2016.02.150252
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发表时间：
2016-03-01
影响因子：
2.9
通讯作者：
Baker, Richard
中科院分区：
文献类型：
--
作者：
Mainous, Arch G., III;Tanner, Rebecca J.;Baker, Richard
背景：糖尿病的患病率日益增加，是一个主要的健康问题。糖尿病前期的检测和治疗可以延缓糖尿病的发病，并提出了一个重要的糖尿病预防策略。方法：使用2012年全国门诊医疗调查的数据，我们研究了年龄≥ 45岁的未诊断糖尿病的成年人在90天内进行HbA（1c）检测的就诊情况。（n = 518次未加权访视; n = 11，167，004次加权访视）。HbA（1c）结果分为正常，糖尿病前期，糖尿病，我们检查患者的特征（年龄，性别，种族，付款人类型，体重指数）和治疗糖尿病前期。结果：在访问的成年人，54.6%的HbA（1c）值正常，33.6%的糖尿病前期，11.9%的糖尿病。在HbA 1c与前驱糖尿病一致的患者访视中，诊断为前驱糖尿病的患者数量太少，无法进行可靠的人群估计。23.0%的诊断或未诊断的前驱糖尿病患者存在病历中的治疗指征（生活方式改变咨询和/或二甲双胍）。最常见的治疗方法是生活方式改变consultations.Conclusions：我们的研究结果表明，有错过的机会，在初级保健糖尿病的预防。提供者需要改变他们对前驱糖尿病的方法，并在预防糖尿病方面发挥更有效的作用。
Background: The increasing prevalence of diabetes is a major health problem. The detection and treatment of prediabetes can delay the onset of diabetes and presents an important diabetes prevention strategy.Methods: Using data from the 2012 National Ambulatory Medical Care Survey, we studied visits by adults aged >= 45 years without diagnosed diabetes who had an HbA(1c) test within 90 days of the visit (n = 518 unweighted visits; n = 11,167,004 weighted visits). HbA(1c) results were categorized into normal, prediabetes, and diabetes, and we examined patient characteristics (age, sex, race, payer type, body mass index) and treatment of prediabetes.Results: Among visiting adults, 54.6% had a normal HbA(1c) value, 33.6% had prediabetes, and 11.9% had diabetes. Of those patient visits with HbA1c consistent with prediabetes, the number of patients diagnosed with prediabetes was too low for a reliable population estimate. Indication of treatment in the medical record (lifestyle modification counseling and/or metformin) was present in 23.0% of those with diagnosed or undiagnosed prediabetes. The most common treatment was lifestyle modification counseling.Conclusions: Our findings show that there are missed opportunities for diabetes prevention in primary care. Providers need to change their approach to prediabetes and play a more effective role in preventing diabetes.