Background
More than 33% of adults in the US have prediabetes yet only 11% report having been diagnosed with the condition (CDC). Lifestyle counseling has been shown to reduce risk for progression to diabetes.
Objective
To evaluate the prevalence of lifestyle counseling for diabetes prevention and demographic associations of adults who have self-reported prediabetes.
Study Design, Settings, Participants
Data include adults who self-reported they were informed by a provider to have prediabetes, be at risk for diabetes and/or be borderline for diabetes (n = 1110) from the National Health and Nutrition Examination Survey 2015-2016.
Measurable Outcome/Analysis
Lifestyle counseling outcomes are weight loss, physical activity and nutrition recommendations. Frequencies of demographics (gender, poverty level, race/ethnicity, age and BMI) are summarized for these outcomes. Chi-square testing determined association for outcomes and multiple logistic regression showed predictive association between outcomes and demographics.
Results
Rates of lifestyle counseling for the self-reported prediabetes population range between 31% - 60%. BMI is associated with all counseling outcomes, with obesity being the largest predictor of provider counseling about weight loss (OR 20.0; CL 7.0, 57.5), physical activity (OR 4.0; CL 2.0, 7.8), reduction of fat/calories (OR 4.4; CL 2.7, 7.4), and reduction of sodium (OR 5.6; CL 2.9, 11.0). Sodium reduction is the only outcome associated with multiple demographics: poverty (P = .0007), race/ethnicity (P < .0001), age (P < .0001), and BMI (P < .0001).
Conclusion
Provider conversations about lifestyle change for diabetes prevention are variable. To better understand how providers give lifestyle counseling to prevent prediabetes progression to diabetes, future research can examine salience of topics, barriers and causes of possible disparities.
Funding: NHANES 2015-2016.
Appendix. Supplementary data
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Copyright
© 2019 Published by Elsevier Inc.
