Different types of medical providers, such as doctors, physicians’ assistants, nurse practitioners, nurses, diabetes educators, registered dietitians, and pharmacists can play critical roles in helping to detect diabetes. Here are some things providers can do:
- Gain and maintain state-of-the-art knowledge about the risk factors for diabetes and pre-diabetes and effective strategies related to testing for and diagnosing the disease. For example, the diagnostic glucose numbers for diabetes and pre-diabetes have been revised in the past few years (See “The Importance of Early Diabetes Detection” in this section for current diagnostic glucose numbers).
- Create opportunities within the health care setting to identify persons at high risk for diabetes, such as asking patients to provide information about diabetes symptoms and risk factors on a pre-visit questionnaire. Knowing a patient has symptoms or risk factors for diabetes can serve as an important prompt for diagnostic testing.
- Assess risk for gestational diabetes. The American College of Obstetricians and Gynecologists (ACOG) advises that it is appropriate to screen all pregnant women for gestational diabetes, whether by patient history, clinical risk factors for gestational diabetes, or a laboratory test to determine blood glucose levels. However, ACOG acknowledges that more research is needed before it can be determined what screening method is best and when it should occur.66 The U.S. Preventive Services Task Force concludes that evidence is insufficient for or against routine screening for gestational diabetes.67
- Establish and implement protocols to ensure that newly diagnosed patients with diabetes are (1) promptly educated about lifestyle changes and diabetes selfmanagement techniques that can delay or prevent complications of diabetes; (2) tested when appropriate for comorbid conditions, such as eye or cardiovascular disease; and (3) involved in developing a plan to control HbA1c, blood pressure, and cholesterol, the “ABCs of diabetes.”68
- Refer patients and provide contact information as needed to additional health care providers to address specific or urgent problems.
- Be a diabetes messenger and help to educate patients and community members about the risk factors and signs and symptoms of diabetes and encourage behavior change. Share information about diabetes detection with community leaders.
- Become involved in research aimed at identifying effective approaches to detect diabetes in various populations, such as children, older persons, and members of specific racial/ethnic groups.
66 American College of Gynecologists. (2001). Pregnant women should be screened for gestational diabetes: Though no one test is ideal. Press release, August 31. Available at: http://www.acog.org/from_home/publications/press_releases/nr08-31-01.cfm. August 31, 2001.
67 U.S. Preventive Services Task Force. Screening for gestational diabetes mellitus: Recommendations and rationale. (February 2003). Agency for Healthcare Research and Quality, Rockville, MD. Available at http://www.ahrq.gov/clinic/3rduspstf/gdm/gdmrr.htm.
68 National Diabetes Education Program. Guiding principles for diabetes care: For health care providers. NIH Publication No. 99-4343. Available at: http://www.ndep.nih.gov/diabetes/pubs/GuidPrin_HC_Eng.pdf.