Background: Quality health care delivery is critical to prevent diabetes-related complications. However, there is limited national information about the extent to which a diverse population of U.S. adults with diabetes receive the American Diabetes Association (ADA) recommended comprehensive diabetes care.

Methods: We conducted a cross-sectional analysis of 4,114 adults aged ≥20 with self-reported diabetes from the National Health and Nutrition and Examination Survey (NHANES) 2005-2016. We estimated the prevalence and identified predictors of receipt of comprehensive diabetes care (i.e., meeting all 5 criteria in the past year: having a primary doctor for diabetes care and number of visits for this doctor ≥1, HbA1c testing, eye exam, foot exam, and cholesterol test).

Results: Among adults with diabetes, 10.9% (95% CI, 9.3-12.6%) had received comprehensive care in the past year (all 5 criteria). Overall, 71.7% (95% CI, 69.6-73.7%) met ≥3 criteria. In a fully adjusted model, those less likely to receive comprehensive care were current smokers, and adults with lower socioeconomic status, lack of insurance, or depression (Table).

Conclusions: Only 1 out of 10 U.S. adults with diabetes receive ADA recommended comprehensive diabetes care. Efforts are needed to improve health care delivery and equity in diabetes care. Insurance status and depression are important modifiable determinants of comprehensive care.


J. Shin: None. D. Wang: None. G. Fernandes: Employee; Spouse/Partner; Janssen Pharmaceuticals, Inc. Employee; Self; Merck Sharp & Dohme Corp. N.R. Daya: None. M. Grams: Other Relationship; Self; DCI. S. Golden: None. S. Rajpathak: Employee; Self; Menarini Group. E. Selvin: None.

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