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Master Thesis

Connaissances et prise en charge du pré-diabète par les médecins généralistes à l’île de La Réunion

Abstract : Introduction: Pre-diabetes is a transitional state between diabetes and normoglycemia. Its prevalence is about 1.5 more than diabetes. An efficient care would reduce the risk of developing type 2 diabetes and cardiovascular diseases. Nowadays, awareness of physicians’ regarding pre-diabetes remains poorly studied. Objectives: To Investigate physicians’ knowledge and attitudes to pre-diabetes. Methods: A cross-sectional study based on electronic surveys was conducted during 4 months among 668 physicians. The questionnaire was elaborated from national recommendations. It was validated and tested before releasing. A descriptive and bi-varied analysis of data was carried out. Results: A total of 121 physicians responded to the questionnaire. Their knowledge about pre-diabetes was good regarding its definition (95 %), its progression (88.4 %) and the necessity of management (86.8 %). Senior physicians better targeted risk factors (sedentary, p < 0.001; precarity, p = 0.03). Even if pre-diabetes’ screening was done by 95,9 % of general practitioners, its prevalence was undervalued. Medical care was mainly based on lifestyle interventions (77.7 %). Diet advices were almost systematically given (92.5 %) but physical activity recommendations were less well known (62.3 %). Physicians perceived some barriers to an effective care including a lack of time (59,5 %) and sustaining patient motivation (76 %). Most of them (93,4%) were favorable to include patients in a therapeutic education program. Conclusion: Awareness of pre-diabetes needs to be raised. Our study showed an underestimation of its prevalence. Prediabetes does not seem to be recognized yet as a disease. Recommendations were not applied consistently in relation to lack of time, supports, and difficulties to sustain patient motivation. This original work was part of the Nutrition-Diabetes program "Dites Non au Diabètes!" which is carried out in three pilot regions. Its limitations are lack of power and memory bias.
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Master Thesis
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Submitted on : Friday, January 31, 2020 - 11:42:12 AM
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Anthony Collet. Connaissances et prise en charge du pré-diabète par les médecins généralistes à l’île de La Réunion. Sciences du Vivant [q-bio]. 2019. ⟨dumas-02462355⟩



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