I don’t often write negative things about my colleagues. But my reaction to this recent bit of news can only be described as outrage.
Because according to a new study, a lot of primary care physicians don’t have the first clue about the dangers of prediabetes. And you know what? There’s simply no excuse for it.
We’ve known for decades now that you can ward off a type 2 diabetes diagnosis by making the right changes at the first sign of trouble. Indeed, I’ve devoted my entire career to exactly this mission.
So the fact that so many doctors can’t be bothered to learn about proper screening, lab work, and lifestyle recommendations? Well, that’s pretty galling.
Dangerous “knowledge gaps”
As part of this latest study, researchers surveyed physicians on their knowledge of prediabetes risk factors, lab criteria for diagnosis, and management strategies. Doctors were also asked for their thoughts on roadblocks to prediabetes management and potential strategies for improvement.
What followed was an absolute joke: For starters, a measly 15 percent of the doctors surveyed were able to identify all of the prediabetes risk factors that would make screening appropriate. Meanwhile, fewer than half knew the lab criteria for diagnosis.
This is preposterous as it is. But it gets so much worse…
A mere 42 percent of the doctors were able to correctly identify a fasting blood sugar level that would indicate prediabetes. And fewer than a third knew the threshold for HbA1c—a critical measure of long-term blood sugar control.
Not to mention, fewer than ten percent knew about recommendations to drop at least seven percent of your body weight to prevent diabetes. (For a 200-pound person, that’s just a 14-pound weight loss—which anyone can manage.)
When it comes down to it, more than one in five doctors were ignoring official prediabetes screening and management guidelines of any kind. And considering the fact that most of these recommendations fall short to begin with, I think it’s safe to say that we have a real problem on our hands.
Too little, too late
If you thought all that was bad, the solution proposed by researchers is the real cherry on top: We should use information technology tools to make things easier for primary care physicians.
But the expectation to remember basic diagnostic criteria, and to follow through on screening and treatment, is exactly what doctors are supposed to do…
And in the midst of this crisis, especially, shouldn’t every physician be doing it?
Prediabetes is one of the simplest conditions to evaluate and manage. (Seriously!) It’s a blood test and a conversation. It may involve a prescription for metformin (which you’d think conventional doctors would be all over, despite it being an old drug that doesn’t rake in much money).
But that’s really it. And yet, per this study, doctors aren’t even meeting this low bar. In fact, a good quarter of them may be identifying patients as having prediabetes when they already have diabetes.
Not only that, but about a third of primary care physicians are referring their diagnosed patients to diabetes prevention programs. (Why they can’t coach their patients themselves is beyond me, but that’s a whole different conversation.) I’ve always made a point of knowing what I don’t know, but apparently, I’m an outlier.
I mean, did these people even go to medical school? Who gave them their licenses to practice? This is why I’m so outraged… and we wonder why we’re caught in a diabesity epidemic with no end in sight.
The fact that most U.S. adults aren’t even aware that they have prediabetes is a tragedy in itself. But the fact that their doctors don’t even know how to screen for it?
Well, that’s pure negligence, plain and simple.
P.S. The good news here is that there are specific nutrition, fitness, and lifestyle interventions that can help you manage your blood sugar and reverse diabetes. All of which I discuss, in detail, in my Metabolic Repair Protocol—a drug-free plan for preventing and reversing type 2 diabetes, prediabetes, and metabolic syndrome. To learn more, or to enroll today, click here now!
“Prediabetes Awareness in the Primary Care Setting.” Medscape Medical News, 10/18/2019. (medscape.org/viewarticle/919839)