Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Jun;44(6):1300-1308.
doi: 10.2337/dc20-2541. Epub 2021 Apr 16.

Trends in Receipt of American Diabetes Association Guideline-Recommended Care Among U.S. Adults With Diabetes: NHANES 2005-2018

Jung-Im Shin  1 , Dan Wang  2 , Gail Fernandes  3 , Natalie Daya  2 , Morgan E Grams  2   4 , Sherita H Golden  2   4 , Swapnil Rajpathak  3 , Elizabeth Selvin  2   4
Affiliations

Trends in Receipt of American Diabetes Association Guideline-Recommended Care Among U.S. Adults With Diabetes: NHANES 2005-2018

Jung-Im Shin et al. Diabetes Care. 2021 Jun.

Abstract

Objective: To characterize national trends and characteristics of adults with diabetes receiving American Diabetes Association (ADA) guideline-recommended care.

Research design and methods: We performed serial cross-sectional analyses of 4,069 adults aged ≥20 years with diabetes who participated in the 2005-2018 National Health and Nutrition Examination Survey (NHANES).

Results: Overall, the proportion of U.S. adults with diabetes receiving ADA guideline-recommended care meeting all five criteria by self-report in the past year (having a primary doctor for diabetes and one or more visits for this doctor, HbA1c testing, an eye examination, a foot examination, and cholesterol testing) increased from 25.0% in 2005-2006 to 34.1% in 2017-2018 (P-trend = 0.004). For participants with age ≥65 years, it increased from 29.3% in 2005-2006 to 44.2% in 2017-2018 (P-trend = 0.001), whereas for participants with age 40-64 and 20-39 years, it did not change significantly during the same time period: 25.2% to 25.8% (P-trend = 0.457) and 9.9% to 26.0% (P-trend = 0.401), respectively. Those who were not receiving ADA guideline-recommended care were more likely to be younger, of lower socioeconomic status, uninsured, newly diagnosed with diabetes, not on diabetes medication, and free of hypercholesterolemia.

Conclusions: Receipt of ADA guideline-recommended care increased only among adults with diabetes aged ≥65 years in the past decade. In 2017-2018, only one of three U.S. adults with diabetes reported receiving ADA guideline-recommended care, with even a lower receipt of care among those <65 years of age. Efforts are needed to improve health care delivery and equity in diabetes care. Insurance status is an important modifiable determinant of receiving ADA guideline-recommended care.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Trend in receipt of ADA guideline-recommended care (all components) among U.S. adults with self-reported diabetes (NHANES 2005–2018). A: Overall participants. B: Participants stratified by age.
See this image and copyright information in PMC

References

    1. Centers for Disease Control and Prevention . National Diabetes Statistics Report, 2020: Estimates of Diabetes and its Burden in the United States. Accessed 9 September 2020. Available from https://www.cdc.gov/diabetes/pdfs/data/statistics/national-diabetes-stat...
    1. Nathan DM. Long-term complications of diabetes mellitus. N Engl J Med 1993;328:1676–1685 - PubMed
    1. Preis SR, Hwang SJ, Coady S, et al. . Trends in all-cause and cardiovascular disease mortality among women and men with and without diabetes mellitus in the Framingham Heart Study, 1950 to 2005. Circulation 2009;119:1728–1735 - PMC - PubMed
    1. American Diabetes Association . Economic costs of diabetes in the U.S. in 2017. Diabetes Care 2018;41:917–928 - PMC - PubMed
    1. American Diabetes Association . 9. Pharmacologic approaches to glycemic treatment: Standards of Medical Care in Diabetes—2021. Diabetes Care 2021;44(Suppl. 1):S111–S124 - PubMed

Publication types