Patient Perceptions About Prediabetes and Preferences for Diabetes Prevention.
The purpose of this study was to explore how adults with prediabetes perceive their risk of developing diabetes and examine their preferences for evidence-based treatment options to prevent diabetes.



A qualitative study was conducted in 2 large Midwest primary care practices, involving in-depth semistructured interviews with 35 adult patients with prediabetes.



This ethnically diverse (77% nonwhite) sample of middle-aged primary care patients exhibited multiple diabetes risk factors. Knowledge gaps about prediabetes and its medical management were pervasive. Most patients overestimated the risk of developing diabetes and were not familiar with evidence-based treatment options for prediabetes. They suggested that receiving brief, yet specific information about these topics during the study interview motivated them to act. The majority of participants considered both intensive lifestyle intervention and metformin acceptable treatment options. Many preferred initial treatment with intensive lifestyle intervention but would take metformin if their efforts at lifestyle change failed and their primary care physician recommended it. Some participants expressed wanting to combine both treatments.



This qualitative study highlights potential opportunities to promote patient-centered dialogue about prediabetes in primary care settings. Providing patients specific information about the risk of developing diabetes and evidence-based treatment options to prevent or delay its onset may encourage action. Physicians' prediabetes counseling efforts should be informed by the finding that most patients consider both intensive lifestyle intervention and metformin acceptable treatment options.
Division of General Internal Medicine and Geriatrics, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA (Dr O'Brien, Ms Vargas, Dr Zimmermann, Dr Ackermann, Dr Kandula)|Center for Community Health, Institute for Public Health and Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA (Dr O'Brien, Ms Moran, Ms Vargas, Dr Ackermann, Dr Kandula)
Matthew J
MJ
O'Brien
Center for Community Health, Institute for Public Health and Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA (Dr O'Brien, Ms Moran, Ms Vargas, Dr Ackermann, Dr Kandula)
Margaret R
MR
Moran
Section of Hospital Medicine, Department of Medicine, University of Chicago Medical Center, Chicago, Illinois, USA (Dr Tang)
Joyce W
JW
Tang
Center for Community Health, Institute for Public Health and Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA (Dr O'Brien, Ms Moran, Ms Vargas, Dr Ackermann, Dr Kandula)
Maria C
MC
Vargas
Northwestern Family Medicine Residency Program, Erie Family Health Center, Chicago, Illinois, USA (Dr Talen)
Mary
M
Talen
Division of General Internal Medicine and Geriatrics, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA (Dr O'Brien, Ms Vargas, Dr Zimmermann, Dr Ackermann, Dr Kandula)|Erie Family Health Center, Chicago, Illinois, USA (Dr Zimmermann)
Laura J
LJ
Zimmermann
Division of General Internal Medicine and Geriatrics, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA (Dr O'Brien, Ms Vargas, Dr Zimmermann, Dr Ackermann, Dr Kandula)|Center for Community Health, Institute for Public Health and Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA (Dr O'Brien, Ms Moran, Ms Vargas, Dr Ackermann, Dr Kandula)
Ronald T
RT
Ackermann
Division of General Internal Medicine and Geriatrics, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA (Dr O'Brien, Ms Vargas, Dr Zimmermann, Dr Ackermann, Dr Kandula)|Center for Community Health, Institute for Public Health and Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA (Dr O'Brien, Ms Moran, Ms Vargas, Dr Ackermann, Dr Kandula)|Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA (Dr Kandula)
Namratha R
NR
Kandula
D000328:Adult; D003924:Diabetes Mellitus, Type 2 / Q000517:prevention & control* / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015146:Midwestern United States; D010342:Patient Acceptance of Health Care / Q000523:psychology*; D057240:Patient Preference; D010465:Perception; D011236:Prediabetic State / Q000523:psychology*; D011320:Primary Health Care / Q000706:statistics & numerical data; D036301:Qualitative Research; D012307:Risk Factors