title: Prediabetes Screening and Treatment in Diabetes Prevention: The Impact of Physician Attitudes.
abstract: Detection and treatment of prediabetes is an effective strategy in diabetes prevention. However, most patients with prediabetes are not identified. Our objective was to evaluate the relationship between attitudes toward prediabetes as a clinical construct and screening/treatment behaviors for diabetes prevention among US family physicians.
  
  
  
  An electronic survey of a national sample of academic family physicians (n 1248) was conducted in 2016. Attitude toward prediabetes was calculated using a summated scale assessing agreement with statements regarding prediabetes as a clinical construct. Perceived barriers to diabetes prevention, current strategies for diabetes prevention, and perceptions of peers were also examined.
  
  
  
  Physicians who have a positive attitude toward prediabetes as a clinical construct are more likely to follow national guidelines for screening (58.4% vs 44.4; P < .0001) and recommend metformin to their patients for prediabetes (36.4% vs 20.9%; P < .0001). Physicians perceived a number of barriers to treatment, including a patient's economic resources (71.9%), sustaining patient motivation (83.2%), a patient's ability to modify his or her lifestyle (75.3%), and time to educate patient (75.3%) as barriers to diabetes prevention.
  
  
  
  How physicians view prediabetes varies significantly, and this variation is related to treatment/screening behaviors for diabetes prevention.
authors.affiliation: From the Departments of Health Services Research, Management, and Policy (AGM, RJT) and Community Health and Family Medicine (AGM, MP, PJC), University of Florida, Gainesville; and the Department of Community Health and Family Medicine, University of Florida, Jacksonville (CBS).
authors.forename: Arch G
authors.initials: AG
authors.lastname: Mainous
authors.affiliation: From the Departments of Health Services Research, Management, and Policy (AGM, RJT) and Community Health and Family Medicine (AGM, MP, PJC), University of Florida, Gainesville; and the Department of Community Health and Family Medicine, University of Florida, Jacksonville (CBS).
authors.forename: Rebecca J
authors.initials: RJ
authors.lastname: Tanner
authors.affiliation: From the Departments of Health Services Research, Management, and Policy (AGM, RJT) and Community Health and Family Medicine (AGM, MP, PJC), University of Florida, Gainesville; and the Department of Community Health and Family Medicine, University of Florida, Jacksonville (CBS).
authors.forename: Christopher B
authors.initials: CB
authors.lastname: Scuderi
authors.affiliation: From the Departments of Health Services Research, Management, and Policy (AGM, RJT) and Community Health and Family Medicine (AGM, MP, PJC), University of Florida, Gainesville; and the Department of Community Health and Family Medicine, University of Florida, Jacksonville (CBS).
authors.forename: Maribeth
authors.initials: M
authors.lastname: Porter
authors.affiliation: From the Departments of Health Services Research, Management, and Policy (AGM, RJT) and Community Health and Family Medicine (AGM, MP, PJC), University of Florida, Gainesville; and the Department of Community Health and Family Medicine, University of Florida, Jacksonville (CBS).
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Carek
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D001786:Blood Glucose / Q000032:analysis; D003920:Diabetes Mellitus / Q000517:prevention & control*; D005194:Family Practice / Q000379:methods / Q000592:standards*; D005260:Female; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D008019:Life Style; D008297:Male; D008403:Mass Screening / Q000592:standards; D008687:Metformin / Q000627:therapeutic use; D008875:Middle Aged; D009042:Motivation; D010353:Patient Education as Topic; D010821:Physicians, Family / Q000523:psychology*; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians' / Q000592:standards; D011236:Prediabetic State / Q000097:blood / Q000188:drug therapy*; D011795:Surveys and Questionnaires; D014481:United States; D055815:Young Adult
chemical_list: D001786:Blood Glucose; D007004:Hypoglycemic Agents; D008687:Metformin
keywords: Attitude; Behavior Therapy; Family; Life Style; Metformin; Motivation; Physicians; Prediabetic State; Surveys and Questionnaires