A simple nurse-based prompt increases screening and prevention counseling for diabetes

Objective: To determine the impact of a simple nurse-based prompt on fasting glucose screening and counseling regarding diet, exercise and weight loss to persons at increased risk for type 2 diabetes. Research design and methods: Patients at risk for diabetes were recruited from 10 primary care practices. Nurses were trained to score a diabetes risk assessment and prompt providers concerning all high-risk subjects. Both univariate and multivariate logistic regression models were used to determine the association between the nurse prompt and subsequent fasting glucose testing or receiving advice for diet, exercise, or weight loss. Results: Of 1176 subjects, 597 were recruited from intervention practices and 579 from control practices. In both the univariate and multivariate models, the intervention group was more likely to receive fasting glucose testing and advice for diet, exercise and weight loss. In the multivariate model, patients in the intervention group were more likely to receive fasting glucose testing (odds ratio 9.3, 95% confidence interval 3.6-24.0), dietary advice (6.1, 3.5-10.7), exercise advice (7.4, 4.0-13.9), and weight loss advice (1.9, 1.1-3.7). Conclusions: A simple nurse-based prompt is an effective tool to increase screening and preventive services for people at risk for type 2 diabetes.