Before people develop type 2 diabetes, they almost always have prediabetes in which blood glucose levels are higher than normal but are not high enough for a diagnosis of diabetes. Some physicians refer to prediabetes as impaired glucose tolerance (IGT) or impaired fasting glucose (IFG), depending on what test was used when it was detected. This condition puts a patient at a higher risk for developing type 2 diabetes. By identifying prediabetes patients early, we, as healthcare providers, have an opportunity to engage patients to significantly reduce their risk of developing diabetes.

ADA provides a diabetes risk screening tool.

 

Additionally, MY HEALTH ADVISOR is a patient engagement tool that calculates a patient's risk for diabetes, heart disease and stroke. The tool provides risk reduction suggestions and allows patient to create their own action plan with patient driven goals. 

 

CDC has developed a proven lifestyle change program that can assist your prediabetic patients from developing full diabetes. It will help patients lower their risk by teaching them how to improve their food choices and increase their physical activity.

 

How does it work?

• Work with a trained lifestyle coach in your community or online to learn the skills you need to make lasting lifestyle changes.
• Learn to eat healthy, add physical activity to your life
• Manage stress, stay motivated and solve problems that can get in the way of healthy changes

To determine if there is a lifestyle change program in your area click here.

 

For additional information on prediabetes, visit the CDC  - National Diabetes Prevention Program webpage. 

 

It is not a new situation, but rather one that nearly every family physician has encountered. Patients present with a chronic disease directly associated with their lifestyle habits and choices, yet they feel unable to improve their conditions. Often, what patients "should do" is obvious to the physician - e.g., lose weight, stop smoking or start exercising. What is not so obvious is why they are so reluctant to take the next step. For patients at a crossroads, this may be the perfect opportunity to introduce the philosophy and technique known as motivational interviewing.

 

Putting Motivational Interviewing into Practice

Dr. McGrogan and staff

Dr. Frank McGrogan, a family practice physician in West Newton, PA, actively uses motivational interviewing (MI) to help his patients. He educated himself about the strategy in 2012 by listening to a self-learning home audio training offered by the American Academy of Family Physicians. "After listening to the training session, motivational interviewing made sense to me as a way to better help my patients," said Dr. McGrogan. "It's not a strategy that will work on everyone. Some of my patients like to be told what to do, particularly my older patients.

 

Dr. McGrogan offered some tips to physicians who are interested in using MI with their patients. "As a physician, it is not easy to give up control. That is not traditional or how we were taught," shared Dr. McGrogan. "But in order for this to work you need to give up a little control to your patients and let them decide how they feel that they can begin to tackle some of the lifestyle changes that need to be implemented in order to better manage their condition." He also encourages physicians to take a course to learn about MI. "Educate yourself about the technique and then begin to implement it a little at a time with your patients so they feel it will be beneficial to them. Gradually work it into your conversations and then at each visit try to add a little." Read the entire article.