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EHR data reveal low rate of follow-up, treatment for prediabetes
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Follow-up, diagnosis and treatment rates for patients identified as having prediabetes are low, according to findings from a retrospective cohort study.
Researchers culled data from a large integrated health delivery system with more than 3 million members. The main data source was integrated electronic health records (EHR), which entails diagnosis, use, pharmacy and laboratory information from all facets of the care system. The researchers evaluated 358,120 adults aged 18 years or older with incident prediabetes, as indicated by fasting plasma glucose (FPG) of 100 mg/dL to 125 mg/dL or HbA1c 5.7% to 6.4%. All patients were identified with prediabetes between 2006 and 2010.
The study sought to evaluate the rates of diagnosis and subsequent treatment in the 6 months after prediabetes was established.
The researchers found that 18% of the patients had their blood glucose levels retested in the 6 months following identification of prediabetes; 13% had been diagnosed with prediabetes/hyperglycemia by a physician; 31% had diabetes, prediabetes or lifestyle specified in the clinical notes; and less than 0.1% had begun a metformin regimen for their condition. Patients whose FPG was between 120 mg/dL and 125 mg/dL had a 31% rate of blood glucose retesting, although initiation of metformin treatment was still <1%.
"In general, those patients with the highest immediate risk of progression to diabetes were somewhat more likely to receive follow up," the study authors wrote. "However, despite evidence from the Diabetes Prevention Program that metformin use in prediabetes patients may slow progression to diabetes, metformin use was low, and did not increase among those at highest risk."
Disclosure: The researchers report no relevant financial disclosures.
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