Prediabetes diagnosis and treatment in primary care

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 hba1c test within 90 days of the visit (n = 518 unweighted visits; n = 11,167,004 weighted visits). hba1c 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 hba1c 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.