Original Article Management of Prediabetes: A Comparison of the Treatment Approaches Utilized by a Family Practice Clinic and an Internal Medicine/Endocrinology Practice

Purpose: 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 phar-macological 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). Conclusion: 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