title: Management of prediabetes: a comparison of the treatment approaches utilized by a family practice clinic and an internal medicine/endocrinology practice.
abstract: OBJECTIVE
  To compare the management of prediabetes between a family practice clinic and internal medicine/endocrinology practice.
  
  
  METHODS
  A randomized, retrospective evaluation of the medical history in 168 eligible patients with a diagnosis of prediabetes or abnormal blood glucose (BG) at a family practice clinic (n = 78) and an internal medicine/endocrinology practice (n = 90).
  
  
  RESULTS
  The internal medicine/endocrinology practice provided more counseling regarding lifestyle modifications (91.1% vs 76.9%, P = .039), specific physical activity recommendations (26.7% vs 7.7%, P = .003), and recommended more patients receive 150 minutes/week of moderate exercise (8.9% vs 1.3%, P = .038). The family practice clinic provided more written dietary information (16.9% vs 13.3%, P = .044) and specific weight loss goals (20.5% vs 6.7%, P = .015). The internal medicine/endocrinology practice initiated pharmacological therapy in more patients (51.1% vs 3.8%, P< .001) and had a significant decrease in fasting BG from baseline compared to the family practice clinic (-9.0 vs -5.6 mg/dL, P< .001).
  
  
  CONCLUSIONS
  Providers are likely to initiate nonpharmacological therapy but may not provide specific education recommended by the American Diabetes Association. The integration of a multidisciplinary team to provide guideline-based nonpharmacologic counseling may be beneficial in improving outcomes in the management of prediabetes.
authors: Department of Pharmacy Practice, Presbyterian College, Clinton, SC, USA.
authors: Zachary L
authors: ZL
authors: Anderson
authors: Department of Pharmacy Practice, Thomas Jefferson University, Philadelphia, PA, USA emily.scopelliti@jefferson.edu.
authors: Emily M
authors: EM
authors: Scopelliti
authors: St Cloud Veterans Affairs Healthcare System, St Cloud, MN, USA.
authors: Jessica M
authors: JM
authors: Trompeter
authors: Department of Pharmacy Practice, Shenandoah University, Winchester, VA, USA.
authors: Dawn E
authors: DE
authors: Havrda
mesh_terms: D000328:Adult; D001786:Blood Glucose; D003376:Counseling; D004032:Diet; D019468:Disease Management; D004704:Endocrinology / Q000379:methods*; D015444:Exercise; D005194:Family Practice / Q000379:methods*; D005260:Female; D006442:Glycated Hemoglobin; D019983:Guideline Adherence / Q000706:statistics & numerical data; D015438:Health Behavior; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D007388:Internal Medicine / Q000379:methods*; D008019:Life Style; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data; D011236:Prediabetic State / Q000188:drug therapy / Q000628:therapy*; D011897:Random Allocation; D012189:Retrospective Studies
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents
keywords: abnormal glucose; impaired fasting glucose; impaired glucose tolerance; prediabetes