Moving from undiagnosed to diagnosed diabetes: the patient's perspective.

BACKGROUND AND OBJECTIVES One third of diabetes cases in the United States are undiagnosed. Knowledge of the patient's experience from symptom recognition to diabetes diagnosis will help clinicians and policy makers optimize their approach to diabetes detection. METHODS We interviewed 15 patients diagnosed with type 2 diabetes within the past 6 months about how they came to be diagnosed and about any barriers that might have prevented their diagnosis. We used grounded theory qualitative methods to approach and analyze the semi-structured interviews. RESULTS Most diagnoses of diabetes in these patients were either serendipitous, symptom driven, or patient initiated. None resulted from physician-initiated screening. Patients had only a superficial knowledge of the symptoms of diabetes prior to diagnosis, despite strong family histories of diabetes. Patients often incorrectly attributed symptoms of diabetes to other causes and sometimes physicians also did this. Barriers of cost, insurance, and trust were not deemed to be important by these patients. CONCLUSIONS Many individuals with undiagnosed diabetes are likely unaware of the relevance of their symptoms. Clinicians must be vigilant in identifying people at risk for diabetes. Improved education of individuals at risk for diabetes may be a useful strategy to increase diabetes detection.