Screening, diagnosing and management of Pacific peoples with prediabetes in New Zealand primary healthcare clinics with high concentrations of Pacific peoples: an online survey
Julienne Faletau
1 * , Rosie Dobson 2 , Vili Nosa 2 , Judith McCool 1
1 Epidemiology and Biostatistics Section, School of Population Health, Faculty of Medical and Health Sciences, The University of Auckland, M&HS Building 507; 28 Park Avenue, Grafton, Auckland, 1023, New Zealand.
2 Pacific Health Section, School of Population Health, Faculty of Medical and Health Sciences, The University of Auckland, M&HS Building 507; 28 Park Avenue, Grafton, Auckland, 1023, New Zealand.
Journal of Primary Health Care 15(2) 162-166 https://doi.org/10.1071/HC23016
Published: 15 May 2023
© 2023 The Author(s) (or their employer(s)). Published by CSIRO Publishing on behalf of The Royal New Zealand College of General Practitioners. This is an open access article distributed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND)
Abstract
Introduction: Prediabetes is a condition of elevated blood sugar levels which can increase the risk of type 2 diabetes (T2D) if not managed effectively. Prediabetes is likely to affect about 24.6% of New Zealand (NZ) adults, with estimates of 29% of the Pacific population currently living with the condition. A prediabetes diagnosis is an opportunity for intervention from trusted primary care providers. The study aim was to describe primary healthcare clinician’s knowledge and practice regarding screening, diagnosing and management of prediabetes in Pacific patients.
Methods: An online survey was conducted with current practicing primary healthcare clinicians between February and April 2021. Eligible participants included clinicians employed in a primary healthcare clinic with over 50% of enrolled patients identified as Pacific.
Results: Primary healthcare clinicians (n = 30) reported that their prediabetes screening, diagnosis and management were aligned with the NZ Ministry of Health clinical guidelines. The most common factors that prompted screening was a family history of T2D (25/30, 83%), ethnicity (24/30, 80%) weight and BMI (24/30, 80%). The initial management practices involved providing recommendations for dietary changes and physical activity (28/30, 93%) and referring patients to a diabetes prevention lifestyle change programme (16/30, 53%).
Discussion: Primary healthcare clinicians are the foremost point of engagement with patients and their fāmili (family) in their health journey. Culturally appropriate tools could be useful to assist healthcare providers to communicate to a higher risk population and most clinicians rely on up to date guidelines for screening and management.
Keywords: diagnosis, management, pacific, prediabetes, primary health care, risk, screening, type 2 diabetes.
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