Prediabetes: Provider Awareness and the Implementation of the Prevent Diabetes STAT Toolkit Resources
Abstract
Increased proactivity and improved management of prediabetes is a growing need amongst providers in the primary care setting. Nearly one third of North Dakota residents over the age of 20 have prediabetes, but only one out of ten are aware of this reversible medical condition. Without early correction and identification, 15-30% of people with prediabetes will develop type 2 diabetes. Based on the need for increased proactivity towards prediabetic management, evidence-based resources were created by the Centers for Disease Control and Prevention and the American Medical Association. The Prevent Diabetes STAT Toolkit was developed to guide medical professionals in assisting their patients at risk for type 2 diabetes and encourage referral to the Diabetes Prevention Program (DPP). The DPP is a lifestyle change program that focuses on promoting weight loss, physical activity, and nutrition education for patients who meet the criteria of a BMI ≥ 25, ≥ age 18, are not currently pregnant and either have a history of gestational diabetes, have been diagnosed with prediabetes, or score high risk on the Prediabetic Risk Assessment.
The project included knowledge surveys, educational presentations, and chart reviews at a rural primary care clinic. The providers’ awareness of prediabetes knowledge, best practice standards, and barriers to practice were identified. An educational module was then presented and the PDS Toolkit resources were dispersed to the staff of the clinic. Overall, the effectiveness of the education was affirmative, despite a high baseline understanding of prediabetes. Prior to implementation, the management of at-risk patients was suboptimal, as preventative action was not taking place. With education and the initiation of the Prediabetes Risk Assessment, PDS Toolkit resources, defined screening standards, and an Epic referral, the providers and ancillary staff showed increased uptake of understanding and improved proactivity towards prediabetes. The findings also displayed adherence to initiating referrals for individuals with prediabetic risk factors, such as obesity, and following implementation. Recommendations can be made regarding the efficacy and importance of preventing type two diabetes through enhanced staff screening awareness, management knowledge, and patient guidance on prediabetes.