Table 3.
Overall prevalence and adjusted ORs of receipt of each component of ADA guideline-recommended care among U.S. adults with self-reported diabetes (NHANES 2005–2018*) (N = 4,069)
| Diabetes doctor | HbA1c testing | Eye examination | Foot examination | Cholesterol testing | |
|---|---|---|---|---|---|
| Overall prevalence, % (SE) | 69.1 (1.0) | 75.0 (0.9) | 62.6 (1.2) | 70.3 (1.2) | 78.5 (1.0) |
| Adjusted OR (95% CI)† | |||||
| Age, years | |||||
| 20–39 | 1 [Reference] | 1 [Reference] | 1 [Reference] | 1 [Reference] | 1 [Reference] |
| 40–64 | 1.88 (1.33–2.65) | 1.09 (0.74–1.61) | 1.44 (1.02–2.03) | 1.22 (0.87–1.72) | 2.43 (1.56–3.79) |
| ≥65 | 1.53 (1.06–2.22) | 1.12 (0.70–1.80) | 2.36 (1.62–3.44) | 1.66 (1.17–2.34) | 3.43 (2.17–5.41) |
| Sex | |||||
| Male | 1 [Reference] | 1 [Reference] | 1 [Reference] | 1 [Reference] | 1 [Reference] |
| Female | 1.11 (0.92–1.35) | 1.06 (0.86–1.30) | 1.04 (0.87–1.24) | 0.95 (0.77–1.16) | 1.10 (0.87–1.38) |
| Race/ethnicity | |||||
| Non-Hispanic White | 1 [Reference] | 1 [Reference] | 1 [Reference] | 1 [Reference] | 1 [Reference] |
| Non-Hispanic Black | 1.11 (0.92–1.34) | 0.54 (0.46–0.73) | 1.12 (0.89–1.41) | 1.02 (0.79–1.32) | 0.73 (0.56–0.95) |
| Mexican American | 0.73 (0.59–0.92) | 0.67 (0.54–0.84) | 0.87 (0.68–1.11) | 0.69 (0.55–0.86) | 0.63 (0.48–0.83) |
| Other | 1.00 (0.72–1.38) | 1.12 (0.77–1.63) | 0.98 (0.71–1.35) | 0.85 (0.63–1.15) | 0.75 (0.53–1.06) |
| Family income | |||||
| Below poverty threshold | 1 [Reference] | 1 [Reference] | 1 [Reference] | 1 [Reference] | 1 [Reference] |
| ≥1 times poverty threshold | 1.39 (1.08–1.78) | 1.57 (1.27–1.95) | 1.57 (1.25–1.96) | 1.28 (0.98–1.69) | 1.25 (0.97–1.60) |
| Missing | 1.52 (1.07–2.18) | 0.97 (0.64–1.48) | 1.08 (0.78–1.49) | 0.93 (0.65–1.32) | 1.59 (1.10–2.32) |
| Education | |||||
| <High school | 1 [Reference] | 1 [Reference] | 1 [Reference] | 1 [Reference] | 1 [Reference] |
| High school degree | 1.01 (0.77–1.33) | 1.65 (1.25–2.16) | 1.09 (0.85–1.40) | 1.15 (0.88–1.51) | 0.94 (0.69–1.30) |
| >High school degree | 1.23 (0.90–1.68) | 3.31 (2.32–4.71) | 1.31 (1.01–1.68) | 1.29 (0.97–1.73) | 1.40 (1.06–1.84) |
| Health insurance | |||||
| No insurance | 1 [Reference] | 1 [Reference] | 1 [Reference] | 1 [Reference] | 1 [Reference] |
| Public insurance | 2.79 (2.07–3.75) | 2.64 (1.91–3.63) | 2.76 (2.09–3.65) | 2.64 (2.03–3.43) | 2.98 (2.09–4.25) |
| Private insurance | 2.34 (1.77–3.10) | 2.97 (2.04–4.31) | 2.04 (1.51–2.76) | 2.39 (1.75–3.25) | 3.76 (2.63–5.38) |
| BMI categories, kg/m2 | |||||
| <25 | 1 [Reference] | 1 [Reference] | 1 [Reference] | 1 [Reference] | 1 [Reference] |
| 25 to <30 | 1.12 (0.82–1.53) | 1.38 (1.01–1.88) | 0.90 (0.66–1.23) | 0.84 (0.60–1.18) | 1.04 (0.76–1.42) |
| ≥30 | 1.55 (1.17–2.05) | 1.43 (1.12–1.91) | 1.10 (0.81–1.48) | 0.94 (0.67–1.32) | 1.18 (0.91–1.53) |
| Missing | 1.35 (0.73–2.49) | 0.92 (0.54–1.56) | 0.98 (0.53–1.81) | 0.74 (0.36–1.53) | 0.73 (0.37–1.43) |
| Current smoker | |||||
| Yes | 1 [Reference] | 1 [Reference] | 1 [Reference] | 1 [Reference] | 1 [Reference] |
| No | 1.16 (0.94–1.43) | 1.17 (0.94–1.46) | 1.52 (1.24–1.86) | 1.15 (0.88–1.49) | 1.27 (0.96–1.67) |
| HbA1c categories | |||||
| <7% (<53 mmol/mol) | 1 [Reference] | 1 [Reference] | 1 [Reference] | 1 [Reference] | 1 [Reference] |
| 7–8% (53–64 mmol/mol) | 2.14 (1.72–2.66) | 1.68 (1.30–2.16) | 1.22 (0.91–1.62) | 1.60 (1.14–2.25) | 1.05 (0.79–1.38) |
| 8–9% (64–75 mmol/mol) | 1.81 (1.34–2.42) | 1.57 (1.08–2.28) | 1.02 (0.73–1.42) | 1.52 (1.03–2.24) | 0.90 (0.60–1.33) |
| >9% (>75 mmol/mol) | 1.22 (0.90–1.64) | 1.24 (0.96–1.60) | 0.94 (0.69–1.27) | 1.17 (0.88–1.55) | 0.72 (0.53–0.99) |
| Missing | 1.33 (0.76–2.32) | 0.83 (0.45–1.52) | 1.04 (0.63–1.70) | 1.07 (0.60–1.92) | 1.43 (0.75–2.73) |
| Time since diabetes diagnosis | |||||
| 0 to <5 years | 1 [Reference] | 1 [Reference] | 1 [Reference] | 1 [Reference] | 1 [Reference] |
| 5 to <15 years | 1.43 (1.12–1.82) | 1.43 (1.13–1.80) | 1.23 (0.92–1.65) | 1.36 (1.09–1.71) | 0.82 (0.61–1.09) |
| ≥15 years | 1.20 (0.95–1.52) | 1.91 (1.46–2.51) | 1.75 (1.27–2.42) | 1.90 (1.46–2.48) | 0.94 (0.69–1.29) |
| Diabetes medication | |||||
| None | 1 [Reference] | 1 [Reference] | 1 [Reference] | 1 [Reference] | 1 [Reference] |
| Noninsulin agents only | 3.35 (2.54–4.42) | 2.04 (1.62–2.58) | 1.47 (1.11–1.94) | 1.99 (1.51–2.62) | 2.23 (1.60–3.13) |
| Insulin | 5.25 (3.94–6.99) | 4.29 (3.21–5.72) | 2.25 (1.61–3.14) | 3.64 (2.56–5.16) | 1.93 (1.34–2.78) |
| Hypertension | |||||
| No | 1 [Reference] | 1 [Reference] | 1 [Reference] | 1 [Reference] | 1 [Reference] |
| Yes | 1.24 (1.03–1.51) | 1.33 (1.06–1.66) | 1.03 (0.84–1.25) | 1.23 (0.99–1.53) | 1.38 (1.09–1.74) |
| Hypercholesterolemia | |||||
| No | 1 [Reference] | 1 [Reference] | 1 [Reference] | 1 [Reference] | 1 [Reference] |
| Yes | 1.44 (1.14–1.81) | 1.55 (1.28–1.88) | 1.24 (0.98–1.56) | 1.40 (1.15–1.70) | 2.82 (2.30–3.46) |
| Cardiovascular disease | |||||
| No | 1 [Reference] | 1 [Reference] | 1 [Reference] | 1 [Reference] | 1 [Reference] |
| Yes | 1.08 (0.82–1.42) | 0.80 (0.63–1.00) | 1.24 (0.98–1.56) | 1.21 (0.96–1.53) | 1.42 (1.12–1.79) |
| Chronic kidney disease | |||||
| No | 1 [Reference] | 1 [Reference] | 1 [Reference] | 1 [Reference] | 1 [Reference] |
| Yes | 0.93 (0.75–1.15) | 0.94 (0.77–1.14) | 1.02 (0.82–1.27) | 1.12 (0.90–1.40) | 0.74 (0.58–0.94) |
| Missing | 0.92 (0.60–1.43) | 0.97 (0.60–1.57) | 1.06 (0.67–1.68) | 0.86 (0.55–1.36) | 0.68 (0.41–1.12) |
| Depressive symptoms | |||||
| No | 1 [Reference] | 1 [Reference] | 1 [Reference] | 1 [Reference] | 1 [Reference] |
| Yes | 0.80 (0.61–1.05) | 0.88 (0.71–1.11) | 0.99 (0.79–1.25) | 0.96 (0.73–1.25) | 0.92 (0.70–1.20) |
| Missing | 1.09 (0.77–1.54) | 0.68 (0.51–0.92) | 0.89 (0.63–1.26) | 1.13 (0.81–1.60) | 1.17 (0.81–1.68) |
*
The 2009–2010 survey cycle was not included.
†
Adjusted for age, sex, race/ethnicity, family income, education, and health insurance. Bold values indicate statistical significance.