Rate and Predictors of Glycemic Testing of Nondiabetic Patients in a Managed Care Population

Unrecognized diabetes is a major public health problem. Approximately one-third of all patients with diabetes are undiagnosed (1). Because treatment of diabetes improves outcomes by reducing complications (234), screening for diabetes is an attractive intervention. The American Diabetes Association therefore recommends screening all adults over 45 years of age every 3 years (and younger if at high risk) (5). One presumption underlying a recommendation for doctors to screen for diabetes is that such surveillance is not part of routine medical care. However, there is a certain level of glucose testing of patients without diabetes that occurs in medical practice, which may or may not represent intentional diabetes screening. The frequency of this ad hoc diabetes screening in medical settings is unknown, as are the factors that lead to this ad hoc screening. The objective of this study was to determine the rate and predictors of glycemic testing in a managed care population.

The study was a retrospective analysis of multiple merged administrative databases of Duke University Medical Center’s Managed Care organization. During the time of the study, Duke Managed Care was a staff-model managed care organization within Duke University Medical Center (DUMC). Administrative records …