How Family Physicians Practice the Principle of Remission Along the Glycemic Continuum

Stephanie T. Fulleborn, Paul F. Crawford, Jeremy T. Jackson, Christy J.W. Ledford

Research output: Contribution to journalArticlepeer-review

Abstract

Introduction: Recent evidence reveals that diabetes and prediabetes (preDM) can be reversed to normal glucose regulation (NGR) through significant weight loss, but how physicians clinically identify the principles of partial and complete remission of diabetes is largely unknown. Methods: As part of the cross-sectional omnibus survey conducted in March 2019 at a professional annual meeting in the United States, physician participants answered case scenario questions about the diagnosis and documentation of patients with preDM and type 2 diabetes (T2DM). Results: Of the registered conference attendees, 387 (72.7%) responded. When presented with the initial case of preDM, 201 physicians (70.8%) selected R73.03 Prediabetes. In a follow-up encounter with improved lab results, 118 physicians (58.7%) indicated that they would not chart any diabetes-related code and 62 (30.8%) would chart preDM again. When presented with the case of T2DM, 256 physicians (90.1%) indicated E11.0–E11.9 Type 2 Diabetes. In the follow-up encounter, only 38 (14.8%) coded a diagnosis reflecting remission from T2DM to prediabetes and 211 (82.4%) charted T2DM. Conclusion: Physicians may be reluctant to document diabetes regression as there is little evidence for long-term outcomes and “downgrading” the diagnosis in the medical record may cause screenings to be missed. Documenting this regression in the medical record should communicate the accurate point on the continuum of glucose intolerance with both the patient and the care team.

Original languageEnglish (US)
JournalJournal of Primary Care and Community Health
Volume11
DOIs
StatePublished - 2020
Externally publishedYes

Keywords

  • disease management
  • documentation
  • obesity
  • prediabetes
  • type 2 diabetes

ASJC Scopus subject areas

  • Community and Home Care
  • Public Health, Environmental and Occupational Health

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