How one physician is helping stop diabetes among her patients


A family practice physician participating in a diabetes prevention screening pilot is seeing how standardization in treatment can help patients stop the progress of prediabetes. 

Meghan Buhler, MD, is one of four physicians in a hospital-owned family practice in Venice, a town in southwest Florida. The average age of Venice residents is 73.

“It’s a huge retirement area,” Dr. Buhler said. “Most of [my patients] would be candidates for this program.”

That program is the YMCA’s Diabetes Prevention Program. Venice is one of 17 communities in the United States where Medicare beneficiaries can participate in this program at no cost until June of next year, thanks to an award from the Center for Medicare and Medicaid Innovation.

Dr. Buhler is participating in the AMA’s Improving Health Outcomes initiative. A pilot in collaboration with the YMCA of the USA is helping physician practices in five of the CMMI communities explore a process for screening patients for prediabetes, referring eligible patients to participate in a local YMCA Diabetes Prevention Program and receive feedback from the program to use in patients’ care plans.

The YMCA’s program is part of the Centers for Disease Control and Prevention’s (CDC) National Diabetes Prevention Program, which offers an evidence-based lifestyle intervention that has been proven to help patients prevent or delay the onset of diabetes. That’s important in an area like Venice, where an estimated 35 percent of local adults has prediabetes, the precursor to type 2 diabetes.

Before the pilot program, Dr. Buhler said her practice had no standardized protocol in place to screen for prediabetes. Now, she’s using tools from the AMA collaboration to screen her patients and refer at-risk patients to the local YMCA. One patient who recently started the program already has lost five pounds.

“[The patient] told me last week, ‘Thank you; it’s really enjoyable, and I’m glad you sent me there,’” she said. 

Dr. Buhler uses a BMI chart from the AMA to show patients what their ideal weight is, which opens the door to talking about how weight loss can reduce their chances of developing type 2 diabetes.

She discusses the YMCA prevention program with patients when they are in her office reviewing their labs. Otherwise, she’ll have a nurse tell them about the program when the nurse calls to discuss lab results.

Her patients are unique, she said—most are retired, and have a lot of time to dedicate to a prevention program. But there still are challenges.

“My patients have the time, and they’re into taking care of themselves,” she said. “But I also think they’re scared of [admitting they have prediabetes].”

She said she understands patients’ fear. Recent studies suggest diabetes prevalence has as much as tripled in recent decades, and data show about two in five Americans will develop type 2 diabetes at some point in their lives. But Dr. Buhler explains that prediabetes can be reversed and that participating in the YMCA program can help.

Use these tools to help your patients understand their diabetes risk:

  • American Diabetes Association type 2 diabetes risk test (log in)
  • CDC diabetes prevention fact sheet

Get more information at AMA Wire® about National Diabetes Month and ways you can help your patients take action to prevent diabetes.