Medical Student Knowledge of Current Recommendations for Glucose Screening and Obesity-Related Risk Assessment in Children

Abstract

Surveillance data regarding diabetes rates among Appalachian youth are limited. Risk factors for type 2 diabetes among children include obesity, food insecurity, physical inactivity, and familial history. Child obesity runs especially high in Appalachian Ohio, where at least 22% of third graders are obese, compared to 14.3% in suburban counties. In addition to this, one in four children in Appalachian Ohio live below the federal poverty level and many can be expected to have parents with type 2 diabetes, given the high prevalence among adults in the region. Therefore, medical students must be knowledgeable about screening recommendations. We distributed a modified version of the National Cancer Institute’s Physician Survey of Practice on Diet, Physical Activity, and Weight Control: Questionnaires on Child/Adolescent Care to osteopathic medical students at one university. Descriptive and frequency analyses were used to analyze students’ knowledge and attitudes related to childhood obesity and diabetes. Participants in this study were 238 first- through fourth-year medical students (62% pre-clinical, 38% in clinical rotations) Time spent working directly with pediatric patients in a clinical setting differed between pre-clinical and clinical students (21.4 ± 62.0 h vs. 129.7 ± 195.8 h, p<0.001 respectively). Most students (74%) indicated being unfamiliar with obesity screening recommendations. Few correctly identified BMI percentile cut-points for child overweight (21.2%), obesity (23.7%), and normal weight (29.4%). Students indicated they would initiate glucose screening approximately 4.5 years earlier in overweight/obese patients with risk factors than those with perceived lower risk (p<0.001). Although students recognize the need for earlier diabetes screening in children with additional risk factors and/or family history, there is a need to emphasize systematic approaches to diabetes risk reduction in medical school. Disclosure E.H. Guseman: None. J. Whipps: None. L.L. Jensen: None. E.A. Beverly: None.