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Mindfulness of Prediabetes and Risk-Reducing Behaviors

Adults aware of their prediabetes status may be more likely to exercise and lose weight

It is well known that physical activity and weight loss has great benefits in preventing diabetes among those with prediabetes. However, studies show that only about 50% of those with prediabetes participate in these risk-reducing behaviors. A key factor in understanding this discrepancy could be related to the awareness of prediabetes. Therefore, a study was performed to examine the influence of prediabetes awareness on the odds of engagement in diabetes risk-reduction behaviors.

Researcher Anjali Gopalan, MD, and her colleagues conducted a pooled cross-sectional analysis that analyzed data from two cycles of the National Health and Nutrition Examination Survey, conducted in 2007 through 2008 and 2009 through 2010. Participants with self-reported diabetes were excluded from the study, and the remaining participants were screened for HbA1c between 5.7% and 6.4%. Those who met the criteria were then further divided into a group based on self-reported prediabetes status. A multivariate logistic regression was used to estimate the impact of prediabetes awareness on the odds of engaging physical activity, weight-loss-related activity and a combination of the two.

In this study, 2,694 subjects met the criteria for prediabetes. However, only 288 subjects from the pool of participants were aware of their status. It was found that subjects who were aware of their prediabetes status were more likely to be involved in any type of weight management compared to subjects unaware (65.9% vs 49.3%; P <0.001) in addition to BMI-appropriate weight management (54.9% vs 38.8%; P < 0.001). Aware subjects were also more likely to engage in both physical activity and weight management (OR = 1.5; 95% CI, 1.1-2), and were also more likely to combine at least 150 minutes per week of moderate activity with at least 7% weight loss in the past year (OR = 2.4; 95% CI, 1.1-5.6).

Overall, authors believe that it is important to diagnose prediabetes and counsel patients about what they can do to prevent progression of the disease; however, it is also believed that this alone may be insufficient for most people.

Practice Pearls:

  • Research suggests that awareness of prediabetes status plays an important role in advocating risk-reducing behaviors.
  • Patients who are aware of their prediabetes status are more likely to engage in both physical and weight management.
  • Although diagnosis and counseling are important in prediabetes, health care providers must create relationships with health care systems, communities and payers to increase the availability of evidence-based, structured lifestyle programs.

Gopalan, Anjali, et al. “Awareness of Prediabetes and Engagement in Diabetes Risk–Reducing Behaviors.” American journal of preventive medicine 49.4 (2015): 512-519.