Following is
from
the section entitled
"Action Steps for Prevention"
from the document "Diabetes: A National
Plan for Action", written in December 2004.
Health Care Providers
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.
From the NDEP
Dec2004
http://aspe.hhs.gov/health/NDAP/NDAP04.pdf
[PDF file]
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