This is one of those stories that just triggers a whole range of emotions. Shock, sadness, and anger. For me, I’m mostly just downright angry…
Because according to some new research, very few primary care doctors know when to screen their patients for prediabetes.
How can that be? We are in the midst of one of the deadliest epidemics in American history… and the people manning the front lines can’t even recognize the condition?
No wonder we’re losing the fight against diabesity. Maybe I really am as alone as I often feel in waging this war.
Either way, something has to be done. And as with most things, I choose to start by arming you with the facts you need… because it looks like, once again, your own doctor can’t be trusted to do it.
In fact, it’s going to be up to you to educate your primary care physician. And yet again be responsible for your own health.
I’m sorry to lay this burden on you, as I’m sure it has become very tiring. But the reality is that we have no one else to rely on, even as the diabetes epidemic continues to skyrocket. And if you still need proof of this sad fact, just consider the maddening results of this latest survey.
Researchers from Johns Hopkins University School of Medicine in Baltimore collected responses from 140 primary care providers attending a medical conference in 2015. And the results were beyond discouraging.
Like the fact that a mere six percent were able to identify the 11 risk factors that warrant screening according to the American Diabetes Association (ADA). (Whose guidelines, it should be noted, are far less stringent than my own — adding insult to injury.)
We went over this last week, but just to remind you, upwards of 90 million adults have prediabetes. A good 70 percent of them will go on to develop full blown diabetes. Needless to say, doctors should know when to intervene.
And knowing when to screen for it is just the first step. As I’m continually reminding my readers, lifestyle changes are the single most effective way to stop diabetes in its tracks. (I lay out actionable steps you can start today in my Metabolic Repair Protocol.) But barely a quarter of these patients are hearing this advice — due in no small part to the fact that they’re entirely unaware they even have the condition. (Never mind the fact that too many doctors today couldn’t refuse a doughnut — or find their way to a gym — if their lives depended on it.)
The majority of this survey’s respondents received training in internal medicine, family medicine, or pediatrics. (This included nine nurse practitioners and a physician assistant.) Well over half had been practicing for a decade or longer.
First and foremost, researchers asked them to identify the ADA’s list of 11 prediabetes risk factors. Namely, an age of 45 years or older, a BMI of 25 or higher, hypertension, high cholesterol, heart disease, a close family history of diabetes, sedentary lifestyle, African-American race, Asian-American race, Latino ethnicity, and a history of gestational diabetes.
Most survey respondents were only able to identify eight of the factors. But even more shockingly, only 17 percent were able to correctly identify the lab values that predicate a prediabetes diagnosis. (Which, according to the ADA, is a fasting glucose level of 100-125 mg/dL, and an HbA1c between 5.7 and 6.4 percent — two important tests I hope you are asking your doctor to order at every blood draw if he or she isn’t already.)
And it just gets worse from there. Only a quarter of the respondents were able to identify the target weight loss for prediabetic patients. (A mere five to seven percent of body weight makes a world of difference, clinically.) And fewer than half were able to identify 150 minutes per week as the minimum recommendation for physical activity.
Absolutely pathetic. These numbers should be at 100 percent — no excuses.
Ultimately, while 42 percent of the doctors responded that the ADA guidelines are helpful, a good 30 percent weren’t even familiar with them. Which means that not only do we have organizations writing up a bunch of specious guidelines. But we have a target audience that’s not paying attention anyway.
How does this benefit anyone? The short answer: It doesn’t.
So you’ll have to excuse me if I cut this short. Last I checked, this country’s little diabetes problem was bigger than ever. And some of us are actually busy doing something to stop it.