Prevalence of Undetected High Risk for Type 2 Diabetes Mellitus in Primary Care: A South Florida Primary Care Practice- Based Research Network Study

Background: The 2004 National Health Interview Survey suggests that 7.0% of adults in the US population have diabetes mellitus (DM). Minority populations in the United States are disproportionately burdened with this disease.Objective: The purpose of this study was to determine the prevalence of DM risk in a cross-section of primary care practices in a large urban area that has considerable proportions of Latino and Caribbean populations and to examine the extent to which primary prevention of DM is provided to this ethnically and economically diverse population.Methods: This was a cross-sectional study of primary care patients presenting to physicians participating in the South Florida Primary Care Practice-Based Research Network and 2 physicians from central and northern Florida. We used a validated instrument to calculate DM risk based on body mass index, family history of DM, age-appropriate physical activity, and obstetric history. We excluded people who self-reported DM, and classified undiagnosed patients into 2 groups: those who recalled receiving information about their high risk for DM and those who did not recall receiving such information.Results: A total of 2836 patients were surveyed; data from 2486 were analyzed. The mean (SD) age of the study sample (N = 2486) was 50.22 (16.38) years, and the majority of the patients were female (n = 1685 67.8%]). Of the 2018 patients without DM, 1013 (50.2%) were at high risk for the disease. Among high-risk patients, 839 (82.8%) reported not having been informed by their physician that they were at risk. Significant differences in DM risk were observed among ethnic groups (P = 0.01), but patient demographics were not associated with informed status in high-risk patients. High body mass index was strongly associated with informed status (P < 0.001).Conclusions: Fewer than I in 5 patients at high risk reported having been informed of their elevated risk. This low rate of patient education may delay preventive measures and may contribute to the disproportionate effect of DM on ethnic groups in whom this disease is more common.