Table 3.

Assessment of whether communication mediates the likelihood of Receiving a Clinical Diagnosis of Diabetic Peripheral Neuropathy among Adults Diabetes Patients with Symptom, DISTANCE (n=4,436)^*

Characteristics	Partially adjusted (see table 2) Model Risk Ratio (95% Confidence Interval)	Basic Model + Health Literacy (n=3733)	Basic Model + Language Proficiency (n=3754)	Basic Model + Discussed Pain (n=3159)	Basic Model + Patient-Provider Communication (n=3402)
Race/Ethnicity (ref white)
African American	0.99 (0.91,1.07)	0.99 (0.91,1.07)	0.99 (0.92,1.08)	0.96 (0.88,1.06)	0.99 (0.91,1.07)
Chinese	0.66 (0.52,0.82)	0.65 (0.52,0.82)	0.70 (0.56,0.88)	0.64 (0.50,0.83)	0.66 (0.52,0.82)
Latino	0.86 (0.77,0.95)	0.85 (0.77,0.94)	0.90 (0.81,1.00)	0.82 (0.73,0.92)	0.86 (0.77,0.95)
Filipino	0.68 (0.59,0.78)	0.68 (0.59,0.78)	0.71 (0.61,0.82)	0.60 (0.51,0.72)	0.68 (0.59,0.78)
Age (ref < 50)
Age 50-64	1.27 (1.1,1.47)	1.27 (1.1,1.46)	1.27 (1.10,1.47)	1.21 (1.04,1.41)	1.27 (1.10,1.47)
Age 65+	1.47 (1.27,1.71)	1.47 (1.27,1.71)	1.47 (1.27,1.71)	1.39 (1.19,1.63)	1.48 (1.27,1.71)
Potential Mediators
Inadequate Health Literacy (ref = no)	--	1.02 (0.94,1.12)	--	--	--
Low English Language Proficiency (ref= no)	--	--	0.80 (0.68,0.94)	--	--
Did not discuss pain with doctor (ref = yes)	--	--	--	0.82 (0.73,0.93)	--
Poor patient- provider communication (ref=perfect score)	--	--	--	--	1.02 (0.93,1.11)

^*All models were adjusted for the same variables as in the partially-adjusted model from Table 2 (educational attainment, BMI, gender, symptom frequency, duration of diabetes, HbA1c>9%, depression, Medicaid status, and the number of outpatient visits). Imputed missing values for all covariates except the potential mediating variables (inadequate health literacy, low English language proficiency, did not discuss pain with doctor and poor patient-provider communication).