Why such low MD referrals for National Diabetes Prevention Program?

James Keck, MD, set out to find if adult patients at an academic family medicine clinic, who were actively screened for prediabetes, received a referral to the Diabetes Prevention Program.

The research team evaluated the electronic health records of 5,360 adult patients at an academic family medicine clinic to determine whether they received pre-diabetes screening, diagnosis and treatment.

They found that:

  • 4,068 (76%) patients received a hemoglobin A1c test.
  • 1,437 (35%) of these patients had a result in the prediabetes range.
    • Of these, only 729 (51%) had a diagnosis of prediabetes their EHR

Even though 35% of patients met the diagnostic cut off for prediabetes, not one of them was referred to a Diabetes Prevention Program.

Keck and colleagues also reviewed 31 surveys from clinicians from the same clinic about their pre-diabetes attitudes, knowledge and practices. Keck noted that even when clinicians are aware of the program, insurance coverage for such programs is low even though more and more insurers are recognizing the wisdom in these prevention programs.

James Keck, a physician at the University of Kentucky, believes this is due to a lack of awareness about the Diabetes Prevention Program in general.

The lack of electronic or streamlined referrals to these programs is another notable barrier, besides perceptions of the clinician and individual of whether the program will be effective.

What can be done about this?

Raising awareness about the National Diabetes Prevention Program is the first step, as well as raising awareness of private insurance and Medicare which now covers such programs. Finally, increasing relationships between clinics and places offering these programs (or encouraging clinics to start up their own programs) is a great step towards removing barriers.

Read more on the full survey results and recommendations on Healio.


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