PRP051: Clinical outcomes of notifying patients of their pre-diabetes status comparing the Caucasian population to the minority

Krishna Patel, MD


Context: It is not known to what extent the diagnosis of pre-diabetes is associated with improved patient health behaviors. Does knowledge of the diagnosis of pre-diabetes, alone, lead to improved A1c and decreased progression to diabetes? Specifically, the objective of this study are to observe the impact of notifying patients of a pre-diabetes diagnosis on lifestyle changes, and whether patients’ awareness of their diagnosis resulted in any improvements in the patient’s Hgb A1c, and if there is, do we expect a significant change between the Caucasian population compared to the minority. Objective: To determine the clinical effect of informing patients in an academic medical center family medicine clinic of their pre-diabetic status, without other intensive prescribed interventions. Study design: retrospective cohort study. Setting or dataset: Academic medical center primary care clinic, data obtained using an electronic medical record. Population studied: inclusion criteria: Family Medicine Clinic patients who between 18 and 65 years of age, has a pre-diabetic status , and had a clinic visit during the year 2018. Exclusion criteria: AU Family Medicine Clinic patients <18 years of age, > 65, pregnant patients, on a medication for diabetic control (metformin), has a diagnosis, or has ever had a diagnosis of diabetes, does not have a follow-up appointment at the Family Medicine Clinic after 15 months of pre-diabetes diagnosis. Intervention/instrument: none. Observational study. We will compare patients that were notified of their pre-diabetes to those who were not notified of their pre-diabetes. Outcome measures: BMI, HbA1c, progression to diabetes. Anticipated Results: there will be significant difference in the ΔHbA1C, Δweight, and percentage of patients informed of pre-diabetic status that progress to a diagnose of diabetes as compared to those not informed of pre-diabetic status after 1-year follow up. Expected Outcome: We expect a more significant change among the Caucasian population compared to the minority.
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Wilson Pace 11/21/2020

Hi Drs. Patel and Seehusen- I have been working on a CDC project looking at novel information that we can find from EHR data on the prevention of T2DM. Our dataset includes up to 9 years of EHR data on over 6M people. The latest paper we just submitted for review looked a the trajectory of people "labeled" with pre-diabetes vs those that clearly have pre-diabetes but no label. The people without a label progressed to frank DM faster though it wasn't clear that any additional interventions were used for people with a label. Our clinical advisors had some interesting conversations about all of this. In any case, a prospective study in the area is worthwhile. Good luck. Happy to talk more about the area if you are interested.

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