Implementation of a prediabetes identification algorithm for overweight and obese Veterans

Tannaz Moin, Laura J. Damschroder, Bradley Youles, Fatima Makki, Charles Billington, William Yancy, Matthew L. Maciejewski, Linda S. Kinsinger, Jane E. Weinreb, Nanette Steinle, Caroline R. Richardson

Research output: Contribution to journalReview articlepeer-review

4 Scopus citations

Abstract

Type 2 diabetes prevention is an important national goal for the Veterans Health Administration (VHA): one in four Veterans has diabetes. We implemented a prediabetes identification algorithm to estimate prediabetes prevalence among overweight and obese Veterans at Department of Veterans Affairs (VA) medical centers (VAMCs) in preparation for the launch of a pragmatic study of Diabetes Prevention Program (DPP) delivery to Veterans with prediabetes. This project was embedded within the VA DPP Clinical Demonstration Project conducted from 2012 to 2015. Veterans who attended orientation sessions for an established VHA weight-loss program (MOVE!) were recruited from VAMCs with geographically and racially diverse populations using existing referral processes. Each site implemented and adapted the prediabetes identification algorithm to best fit its local clinical context. Sites relied on an existing referral process in which a prediabetes identification algorithm was implemented in parallel with existing clinical flow; this approach limited the number of overweight and obese Veterans who were assessed and screened. We evaluated 1,830 patients through chart reviews, interviews, and/or laboratory tests. In this cohort, our estimated prevalence rates for normal glycemic status, prediabetes, and diabetes were 29% (n = 530), 28% (n = 504), and 43% (n = 796), respectively. Implementation of targeted prediabetes identification programs requires careful consideration of how prediabetes assessment and screening will occur.

Original languageEnglish (US)
Pages (from-to)853-862
Number of pages10
JournalJournal of Rehabilitation Research and Development
Volume53
Issue number6
DOIs
StatePublished - 2016

Bibliographical note

Funding Information:
This material was based on work supported by the VA (awards XVA 41?048, RRP 12?440, and SDP 12?549). Dr. Moin received support from the VA Office of Academic Affiliations through the VA Health Services Research and Development Advanced Fellowship Program (award TPM65?010), VA Greater Los Angeles, from 2011 to 2014.

Keywords

  • Diabetes
  • Diabetes prevention
  • Guidelines
  • Health services research
  • Implementation research
  • Obesity
  • Prediabetes
  • Screening
  • Veterans
  • Weight management

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