title: Novel use and utility of integrated electronic health records to assess rates of prediabetes recognition and treatment: brief report from an integrated electronic health records pilot study.
abstract: OBJECTIVE
  This study uses novel methods to examine the frequency of diagnosis and treatment of prediabetes in real-world clinical settings using electronic health record (EHR) data.
  
  
  METHODS
  We identified a cohort of 358,120 adults with incident prediabetes (fasting plasma glucose [FPG] 100-125 mg/dL or glycated hemoglobin 5.7-6.4% [39-46 mmol/mol]) between 2006 and 2010 and examined rates of diagnosis and treatment in the 6 months after identification.
  
  
  RESULTS
  In the 6 months after identification of prediabetes, 18% of patients had their blood glucose levels retested; 13% received a physician diagnosis of prediabetes/hyperglycemia; 31.0% had prediabetes, diabetes, or lifestyle documented in the clinical notes; and <0.1% initiated metformin. Among patients with FPG 120-125 mg/dL, 31% were retested; metformin initiation remained <1%.
  
  
  CONCLUSIONS
  Documented rates of follow-up and treatment for prediabetes are low. EHR data may be a valuable tool to improve identification and treatment of prediabetes in the U.S.
authors.affiliation: Corresponding author: Julie A. Schmittdiel, julie.a.schmittdiel@kp.org.
authors.forename: Julie A
authors.initials: JA
authors.lastname: Schmittdiel
authors.forename: Sara R
authors.initials: SR
authors.lastname: Adams
authors.forename: Jodi
authors.initials: J
authors.lastname: Segal
authors.forename: Marie R
authors.initials: MR
authors.lastname: Griffin
authors.forename: Christianne L
authors.initials: CL
authors.lastname: Roumie
authors.forename: Kris
authors.initials: K
authors.lastname: Ohnsorg
authors.forename: Richard W
authors.initials: RW
authors.lastname: Grant
authors.forename: Patrick J
authors.initials: PJ
authors.lastname: O'Connor
mesh_terms: D000328:Adult; D000368:Aged; D001786:Blood Glucose / Q000032:analysis; D057286:Electronic Health Records / Q000706:statistics & numerical data*; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011236:Prediabetic State / Q000175:diagnosis*
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin; C517652:hemoglobin A1c protein, human