title: Recommendations of community pharmacists and health food store employees regarding undiagnosed symptoms of diabetes.
abstract: BACKGROUND
  Consumers may seek health advice from health food store employees (HFSEs) and pharmacists. Delays in the diagnosis of time-critical illnesses may increase the likelihood of morbidity, mortality and healthcare expenditures.
  
  
  OBJECTIVE
  To describe the information provided by HFSEs and pharmacists for symptoms of undiagnosed Type 1 diabetes.
  
  
  METHODS
  A standardized actor portrayed a consumer with symptoms of Type 1 diabetes at eight community pharmacies and 12 health food stores (HFSs) in Pittsburgh, Pennsylvania, and Chapel Hill and Durham, North Carolina. He inquired about potential diagnoses, the need to see a physician, and product recommendations.
  
  
  METHODS
  The subjects included twelve HFSEs and eight licensed pharmacists.
  
  
  RESULTS
  Four of eight (50%) pharmacists and two of 12 (17%) HFSEs mentioned diabetes as a potential diagnosis. Although six pharmacists recommended urgent physician follow-up, only two HFSEs did so; two HFSEs explicitly advised against a physician visit. One pharmacist recommended a product. Nine HFSEs recommended at least one product (monthly costs, range: $24.70-$209.96).
  
  
  CONCLUSIONS
  Even when presented with classic symptoms of Type 1 diabetes, under-recognition of diabetes was common among HFSEs and community pharmacists. Delays in treatment present a health risk to consumers. Further research could confirm these results and inform educational interventions to improve diabetes recognition by both groups.
authors.affiliation: Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
authors.forename: Dio
authors.initials: D
authors.lastname: Kavalieratos
authors.forename: Morris
authors.initials: M
authors.lastname: Weinberger
authors.forename: Jaya K
authors.initials: JK
authors.lastname: Rao
mesh_terms: D000328:Adult; D003132:Commerce / Q000706:statistics & numerical data; D003922:Diabetes Mellitus, Type 1 / Q000175:diagnosis*; D037001:Directive Counseling / Q000379:methods / Q000706:statistics & numerical data; D058870:Food, Organic / Q000706:statistics & numerical data*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D009657:North Carolina; D016544:Patient Simulation; D010414:Pennsylvania; D010594:Pharmacies / Q000706:statistics & numerical data*; D010595:Pharmacists / Q000706:statistics & numerical data*; D010865:Pilot Projects; D012017:Referral and Consultation / Q000706:statistics & numerical data*; D055815:Young Adult