Prevalence and predictors of delayed clinical diagnosis of Type 2 diabetes: a longitudinal cohort study

Gopalan, Anjali; Mishra, Pranita; Alexeeff, Stacey; Blatchins, Maruta A.; Kim, E.; Man, Alan; Grant, Richard W.

doi:10.1111/dme.13808

Cited by 24 publications

(19 citation statements)

References 28 publications

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“…Implementation of optimal diabetes management requires an organized systematic approach and the involvement of a coordinated and dedicated team, which can often be lacking in clinical practice [17]. Importantly, there are also often delays in diagnosis, creating a greater burden of disease after onset of complications [18].…”

Section: Introductionmentioning

confidence: 99%

Management of Type 2 Diabetes in Developing Countries: Balancing Optimal Glycaemic Control and Outcomes with Affordability and Accessibility to Treatment

et al. 2019

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Why carry out this study? Diabetes mellitus is becoming a global epidemic but it disproportionally affects poorer developing countries. Newer agents, although increasingly recognized by some international guidelines, are not always widely accessible and affordable, unlike long-standing drugs such as sulfonylureas (SUs) This review considers existing antidiabetic drugs and makes a case for appropriateness of SUs, especially newer generation SUs What was learned from the study? The newer drugs like DPP4 inhibitors, SGLT2 inhibitors and GLP-1 receptor agonists, while showing benefits, may not be affordable and accessible for many individuals in developing countries The newer generation SUs like gliclazide and glimepiride are time-tested, effective, safe and should continue to be used especially in resource-restricted settings

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Section: Introductionmentioning

confidence: 99%

Management of Type 2 Diabetes in Developing Countries: Balancing Optimal Glycaemic Control and Outcomes with Affordability and Accessibility to Treatment

et al. 2019

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“…Similar studies were launched in Europe and Australia, but without such spectacular effect [16][17][18]. Nevertheless, the authors of all the relevant studies agree that healthcare professionals, especially family doctors and primary care paediatricians, are the most important targets for education [19,20]. According to our survey data, most Polish medical specialists and young physicians during training have some general knowledge about DM1, its symptoms, and diagnosis.…”

Section: Discussionmentioning

confidence: 54%

Can primary care physicians recognize type 1 diabetes in children on time?

Wójcik¹,

Wasyl-Nawrot²,

Starzyk³

2021

pedm

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Introduction Although the diagnostic criteria for diabetes in children and adolescents should be widely known to all healthcare professionals, many cases of type 1 diabetes (DM1) are still not recognized in time. The aim of this study was to compare the experiences with the diagnosis of DM1 of young doctors during training and specialists working as primary health care physicians in Poland. Material and methods 50 specialists in paediatrics or family medicine (average professional experience of 14.6 years) and 50 doctors, and those without specialization (up to 4 years after graduating from medical studies, average professional experience of 1.4 years) participated in the survey. The questionnaires were conducted from November 2019 to November 2020. Results Most of the study participants correctly answered the questions about the diagnostic criteria of diabetes and its management at the moment of diagnosis, except for the question regarding diagnostic criteria for diabetes in oral glucose tolerance test. The correct answers varied from 96% to 72% among medical specialists and physicians during the training, respectively. What is interesting is the relatively small number of diagnosed cases of DM1 during the entire professional career of specialists (0-12 cases), compared to the doctors without specialization (0-5 cases). Medical specialists declared more frequently the use of a glucometer in their daily practice (mean 6 vs. 1, p < 0.05), but after taking into account the years of experience, the difference was insignificant. Conclusions It is important to educate primary care physicians, despite their professional experience. Practical education of physicians is also necessary.

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“…The exclusion criteria were as follows: patients with prior type 2 DM diagnosed before 1 January 2018 (as determined by ICD-10 codes [E11-E11.9], use of antidiabetic medications, or diagnosis text in the medical record data from the Hospital Information System [HIS]), those diagnosed at the first visit, those with gestational diabetes, and those with a history of oral corticosteroid use. Based on a study in the U.S. [ 4 ], the sample size for the study was calculated using a prevalence of 0.3 and a marginal error of 0.05. The target sample size was 323.…”

Section: Methodsmentioning

confidence: 99%

“…Delayed diagnosis of type 2 DM was defined when a lab diagnosis (i.e., hemoglobin A1c [HbA1c] ≥6.5%) of diabetes was conducted without a clinical diagnosis [ 4 ]. The overall global prevalence of delayed diagnosis was 23%–74% [ 5 , 6 ].…”

Section: Introductionmentioning

confidence: 99%

Prevalence and Associated Factors of Delayed Diagnosis of Type 2 Diabetes Mellitus in a Tertiary Hospital: A Retrospective Cohort Study

Dulyapach¹,

Ngamchaliew²,

Vichitkunakorn³

et al. 2022

Int J Public Health

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Objective: To determine the prevalence and associated factors of delayed diagnosis of type 2 diabetes mellitus (DM) among outpatients in a tertiary hospital.Methods: This retrospective cohort study was conducted among outpatients aged ≥35 years with twice fasting plasma glucose (FPG) levels ≥126 mg/dl between 1 January 2018, and 31 December 2020. The prevalence and pattern of delayed diagnosis of DM were defined using the Thai Clinical Practice Guideline (CPG) for Diabetes, 2017, and the American Diabetes Association (ADA) 2017. The cut-off time for FPG level confirmation of 3 months was used to evaluate delayed diagnoses and associated factors. Multiple logistic regression was used to identify variables associated with delayed diagnoses.Results: Of 260 participants, 96.9% and 85.4% had delayed diagnoses as defined by the Thai CPG and the ADA, respectively. Factors significantly associated with delayed diagnosis were hypertension, non-cash insurance, and >10 years of physician experience.Conclusion: Undiagnosed diabetes and diagnosis delay should be a concern in tertiary settings. Senior physicians should focus on patients with higher FPG levels, particularly those who have hypertension, and use non-cash insurance schemes.

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Prevalence and predictors of delayed clinical diagnosis of Type 2 diabetes: a longitudinal cohort study

Cited by 24 publications

References 28 publications

Management of Type 2 Diabetes in Developing Countries: Balancing Optimal Glycaemic Control and Outcomes with Affordability and Accessibility to Treatment

Management of Type 2 Diabetes in Developing Countries: Balancing Optimal Glycaemic Control and Outcomes with Affordability and Accessibility to Treatment

Can primary care physicians recognize type 1 diabetes in children on time?

Prevalence and Associated Factors of Delayed Diagnosis of Type 2 Diabetes Mellitus in a Tertiary Hospital: A Retrospective Cohort Study

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