Addressing Lifestyle Management During Visits Involving Patients with Prediabetes: NAMCS 2013–2015

Delivery of healthcare provider’s lifestyle advice and lifestyle behavioural change in adults who were overweight or obese in pre-diabetes management in the USA: NHANES (2013–2018)

“…First, more than 75% of adults who were overweight or obese and reported pre-diabetes received a provider's advice to reduce the risk for diabetes through lifestyle change, much higher than the prevalence (23%) reported in a general prediabetes population not limited to overweight or obesity status. 9 Second, a disparity between Hispanics and non-Hispanic whites was identified in this study's population in regard to receiving provider's advice about lifestyle management. Finally, receiving advice from a provider significantly increased the likelihood of lifestyle change.…”

“…Open access adoption of implementing pre-diabetes treatment guidelines in clinical practice is lacking. [9][10][11][12] When comparing those who know they have pre-diabetes to those with normal fasting serum glucose, those with pre-diabetes were more likely to report positive behavioural change such as weight control, increased exercise and fat and caloric reduction. 13 Yet less than 25% of patients with prediabetes reported having received lifestyle change advice during an office visit with their medical providers.…”

“…13 Yet less than 25% of patients with prediabetes reported having received lifestyle change advice during an office visit with their medical providers. 9 There is a gap in our knowledge about the associations between the evidence-based practice guideline supporting lifestyle change, physician utilisation of that the guideline to provide advice during office visits and subsequent change in patient behaviour. Obesity has been identified as a risk factor for diabetes.…”

Comparison of National Data Sources to Assess Preventive Care in the US Population

“… 50 , 51 Analyses with NAMCS have considered provider factors; for example, finding that primary care providers provide a majority of outpatient care for patients with diabetes, 52 but that lifestyle management is addressed in just one-quarter of office-based encounters. 53 Studies with HRS, which in our opinion offers more in-depth analysis of diabetes than PSID, have considered the impact of sociodemographic factors on diabetes incidence and mortality, such as stress, marital quality, and food insecurity. 54 – 56 We note that for all surveys, it is possible to assess disparities in these topics by sex and race/ethnicity.…”

“…50,51 Analyses with NAMCS have ‡NHANES and NHIS offer both public and restricted mortality linkages; the former contains broad cause-of-death (e.g., cardiovascular disease) while the latter contains exact dates and ICD-9/10 level cause-of-death ¶Additionally, MEPS offers a restricted linkage to the original NHIS questions which were asked of the same participants in the year prior to their initial MEPS participation considered provider factors; for example, finding that primary care providers provide a majority of outpatient care for patients with diabetes, 52 but that lifestyle management is addressed in just one-quarter of office-based encounters. 53 Studies with HRS, which in our opinion offers more in-depth analysis of diabetes than PSID, have considered the impact of sociodemographic factors on diabetes incidence and mortality, such as stress, marital quality, and food insecurity. [54][55][56] We note that for all surveys, it is possible to assess disparities in these topics by sex and race/ethnicity.…”