Abstract
Background and aims: While predictive tools are being developed to identify those at highest risk for developing diabetes, little is known whether these assays affect clinical care. Methods and results: Thirty sites who used the PreDx® (Tethys BioScience, Emeryville, CA) abstracted clinical information from baseline clinic visits prior to a PreDx test and from the most recent visit at time of abstraction. All visits occurred between May 2008-April 2011 (median follow-up 198 days, IQR 124-334). The primary analysis was the influence of the PreDx test (5-year diabetes prediction) on subsequent care; descriptive statistics were used to summarize baseline and follow-up variables. Overall 913 patients with 2 abstracted visits were included. Relative to baseline, median SBP decreased 1.5mmHg (p=0.039), DBP decreased 2mmHg (p<0.001), LDL-C decreased 4mg/dL (p=0.009), and HDL-C increased 2mg/dL (p<0.001) at follow-up. Behavioral or lifestyle counseling was not significantly different from baseline to follow-up (71.2% vs. 68.1% (p=0.077), but BMI was lower by 0.2kg/m2 at follow up (p=0.013). At follow-up, more patients were prescribed metformin (13.7% vs. 9.7%, p<0.001). A higher PreDx score was significantly associated with metformin prescription (p=0.0003), lifestyle counseling (p=0.0099), and a lower BMI at follow-up (p=0.007). Conclusion: The use of a prognostic test in patients perceived to be high risk for diabetes was associated with a modest but significant increase in the prescription of metformin and lifestyle interventions and a reduction in BMI.
Original language | English (US) |
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Pages (from-to) | 400-407 |
Number of pages | 8 |
Journal | Nutrition, Metabolism and Cardiovascular Diseases |
Volume | 24 |
Issue number | 4 |
DOIs | |
State | Published - Apr 2014 |
Keywords
- Diabetes mellitus
- Quality improvement
- Risk prediction
ASJC Scopus subject areas
- Medicine (miscellaneous)
- Endocrinology, Diabetes and Metabolism
- Nutrition and Dietetics
- Cardiology and Cardiovascular Medicine