One in three Americans has prediabetes, the precursor to type 2 diabetes, and certain patient populations are more susceptible to developing this disease. Use National Diabetes Month this November to learn which of your patients may be at higher risk—and what you can do about it.
Recently released draft diabetes screening guidelines suggest screening certain racial or ethnic minority groups for prediabetes, including patients who are African American, Hispanic/Latino, American Indian, Asian American or Pacific Islander. Meanwhile, studies show low-income populations suffer disproportionately from poor health outcomes associated with prediabetes. Obesity and lack of physical activity also are risk factors.
In addition to these factors, the American Diabetes Association (ADA) has compiled socioecological perspectives physicians should consider when talking to patients about prediabetes and type 2 diabetes.
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The “built” environment. Homes, schools, workplaces, highways and neighborhoods all have an effect on how your patients access amenities. Research shows that disadvantaged groups—including racial and ethnic minorities, people in rural areas and other underrepresented populations—tend to live in communities where there is residential segregation, inadequate housing transportation and limited access to education and health care.
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Access to healthy food. Food deserts disproportionately affect lower-income, minority and rural neighborhoods, while access to fast food restaurants is higher in lower-income and minority communities. At the same time, food insecurity—limited or uncertain access to food because of insufficient financial resources—is associated with a twofold risk of diabetes compared with those without food insecurity.
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Walkability and safe “green” spaces. Areas that aren’t easy to navigate on foot, and locations that don’t have safe parks or recreation areas, don’t encourage exercise. According to the ADA, an analysis reported a 6 percent increase in likelihood of obesity with each additional hour spent in a car per day. Meanwhile, there is a 4.8 percent decrease in likelihood of obesity with each additional kilometer walked per day.
While physicians may not be able to radically alter the socioecological problems in their patients’ communities, physicians can be knowledgeable of community resources that can help patients at high risk for prediabetes. The ADA’s community resources Web page can connect physicians and patients to local programs.
As part of its Improving Health Outcomes initiative, the AMA is working with the YMCA of the USA to explore a process for physicians to screen patients for prediabetes, refer eligible patients to participate in the local YMCA Diabetes Prevention Program and receive feedback from the program to use in patients’ care plans.
The YMCA’s program is part of the CDC’s National Diabetes Prevention Program, which offers an evidence-based lifestyle change program that has been proven to help patients prevent or delay the onset of diabetes. Find a CDC program in your community.
Learn how to determine whether your patients have prediabetes.
Get more information at AMA Wire® about National Diabetes Month and ways you can help your patients take action to prevent diabetes.
