Addressing Underdiagnosed Diabetes Prevents Complications, Increased Mortality Rates
A significant number of patients remain unaware of their diabetes, signaling a need for better diagnostic efforts.
Pharmacists play a significant role in identifying and addressing undiagnosed diabetes, which is a major public health challenge. Despite the availability of screening for diabetes, a significant number of patients with diabetes remain unaware of their condition.
A significant number of patients remain unaware of their diabetes, signaling a need for better diagnostic efforts. | Image Credit: Andrey Popov - stock.adobe.com
Recent CDC data estimate that 8.7 million Americans—representing approximately 22.8% of all diabetes cases—remain undiagnosed, disproportionately affecting uninsured and marginalized populations.1 Individuals lacking insurance are particularly vulnerable, with a significantly higher rate of undiagnosed diabetes compared with insured individuals.2 Undiagnosed diabetes worsens prognosis across various care settings and is associated with increased mortality and development of chronic complications, including retinopathy, albuminuria, and cardiovascular disease. The economic implications are substantial, costing billions annually in preventable complications.3
Addressing undiagnosed diabetes requires a comprehensive strategy encompassing clinical practice enhancements, policy interventions, and technological solutions. According to the US Bureau of Labor Statistics, pharmacists hold approximately 337,700 jobs nationwide.4 Pharmacists working in the community are among the most accessible health care providers, creating numerous opportunities for screening and intervention.
Pharmacists can offer screening services to identify individuals at risk and incorporate simple screening methods into current services and workflow processes, helping to diagnose the condition earlier. They are well positioned to assess patients’ risks for developing diabetes, recognizing factors such as family history, obesity, physical inactivity, high blood pressure, and high cholesterol.
Some pharmacists advocate for expanded abilities to order and interpret lab results, including hemoglobin A1c tests. Once individuals with elevated blood glucose levels are identified, pharmacists can refer them to other members of the health care team for formal diagnosis and treatment initiation. Pharmacists can collaborate with other health care providers to create individualized treatment plans and improve outcomes.5 On average, a person with diabetes visits a pharmacist more frequently than other health care providers, creating numerous opportunities for screening and intervention.6
In addition to identification, pharmacists can help with patient education by providing counseling on the management of diabetes, including but not limited to medication use, lifestyle modifications, and self-monitoring of blood glucose with continuous glucose monitoring or glucose monitors. Pharmacists with collaborative practice agreements can initiate, adjust, and monitor drug therapy, leading to improved glycemic control and improved outcomes. In many underserved communities, pharmacists can provide accessible diabetes care such as education on lifestyle and nutrition. Medication refill pickups also serve as natural opportunities for pharmacists to assess adherence and provide monitoring and counseling services.
By leveraging their advanced clinical training, frequent direct patient interactions, and deeply rooted trust within the populations they serve, pharmacists can play an instrumental role in the early identification of undiagnosed diabetes, facilitating prompt referral to appropriate care and timely initiation of evidence-based therapeutic interventions.
To maximize the impact of pharmacists in this capacity, it is essential to fully integrate them into multidisciplinary, value-based care models. Such integration fosters a more cohesive and efficient health care delivery system while concurrently addressing the persistent challenges faced by community pharmacists, including inadequate reimbursement mechanisms and significant time constraints. Empowering pharmacists through these structural and systemic enhancements enables them to more effectively fulfill their critical role in chronic disease prevention, early intervention, and ongoing management within the broader health care continuum.
To read these stories and more, download the PDF of the Drug Topics May/June issue here.
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