title: Awareness of Prediabetes and Engagement in Diabetes Risk-Reducing Behaviors.
abstract: BACKGROUND
  Studies have demonstrated the benefit of weight loss and physical activity for diabetes prevention among those with prediabetes. Despite this evidence, only about half of people with prediabetes report engaging in these behaviors. One presumed barrier is low patient awareness of prediabetes. The purpose of this study is to examine the impact of prediabetes awareness on the odds of engagement in diabetes risk-reduction behaviors.
  
  
  METHODS
  A pooled cross-sectional analysis of adults from two cycles (2007-2008, 2009-2010) of the National Health and Nutrition Examination Survey was conducted. Those with prediabetes were identified by excluding people with self-reported diabetes and then screening for hemoglobin A1c values between 5.7% and 6.4%. This group was then divided based on self-reported prediabetes. Multivariate logistic regression was used to estimate the effect of prediabetes awareness on the odds of engagement in physical activity, weight management, and the combination of physical activity and weight management.
  
  
  RESULTS
  Of those meeting the defined criteria for prediabetes (n=2,694), only 11.8% (n=288) were aware of their status. Prediabetes-aware individuals had higher odds of engagement in the combination of moderate physical activity plus BMI-appropriate weight management (AOR=1.5, 95% CI=1.1, 2.0), and the combination of at least 150 minutes/week of moderate activity and 7% weight loss in the past year (AOR=2.4, 95% CI=1.1, 5.6).
  
  
  CONCLUSIONS
  Prediabetes-aware adults have increased odds of engagement in physical activity and weight management. Increasing patients' awareness of prediabetes could result in increased performance of exercise and weight management behaviors and, most importantly, decreased risk of future diabetes.
authors.affiliation: Philadelphia Veterans Affairs Medical Center, Philadelphia, Pennsylvania; Robert Wood Johnson Clinical Scholars Program, University of Pennsylvania, Philadelphia, Pennsylvania. Electronic address: agopalan@upenn.edu.
authors.forename: Anjali
authors.initials: A
authors.lastname: Gopalan
authors.affiliation: Division of Endocrinology, Diabetes, and Metabolism, University of Pennsylvania, Philadelphia, Pennsylvania.
authors.forename: Ilona S
authors.initials: IS
authors.lastname: Lorincz
authors.affiliation: Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.
authors.forename: Christopher
authors.initials: C
authors.lastname: Wirtalla
authors.affiliation: School of Social Policy and Practice, University of Pennsylvania, Philadelphia, Pennsylvania; Philadelphia Veterans Affairs Center for Health Equity Research and Promotion, Philadelphia, Pennsylvania.
authors.forename: Steven C
authors.initials: SC
authors.lastname: Marcus
authors.affiliation: Philadelphia Veterans Affairs Medical Center, Philadelphia, Pennsylvania; Division of General Internal Medicine, University of Pennsylvania, Philadelphia, Pennsylvania; Philadelphia Veterans Affairs Center for Health Equity Research and Promotion, Philadelphia, Pennsylvania.
authors.forename: Judith A
authors.initials: JA
authors.lastname: Long
mesh_terms: D001835:Body Weight; D003430:Cross-Sectional Studies; D015444:Exercise; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011236:Prediabetic State / Q000517:prevention & control / Q000523:psychology*