Background: Diabetes self-management education and support services empower people with diabetes to follow preventive care practices that reduce disease complications.

Objective: We describe self-reported receipt of diabetes education among people with diabetes, and its association with following recommended self-care and clinical preventive care practices.

Methods: We analyzed data from the 2017 Behavioral Risk Factor Surveillance System for 42,631 adults (≥18 years) with self-reported diabetes (all types) in 38 states, D.C., and Guam. Diabetes education was defined as ever taking a diabetes self-management class. We assessed four self-care practices (daily glucose testing, daily foot checks, smoking abstention, and regular physical activity), and six clinical practices (pneumococcal vaccination, biannual HbA1c test, and an annual dilated eye exam, influenza vaccination, healthcare visit for diabetes, and foot exam). We used multivariable logit regression with predicted margins to predict the probability of following these practices, by diabetes education, controlling for sociodemographic factors.

Results: Of adults with diabetes, 52.3% reported receiving diabetes education; those who did had a higher (p<0.01) predicted probability for 3 of 4 self-care practices [daily glucose testing (70.1% vs. 51.2%, respectively), daily foot check (62.6% vs. 52.2%), and regular physical activity (65.6% vs. 56.9%)] and all 6 clinical practices [pneumonia vaccination (72.8% vs. 59.1%), biannual HbA1c test (81.5% vs. 70.4%), and an annual eye exam (74.3% vs. 65.7%), flu vaccination (60.0% vs. 54.2%), healthcare visit (92.3% vs. 86.2%), and medical foot exam (83.0% vs. 68.5%)].

Conclusions: Diabetes education was positively associated with following preventive care practices. Developing strategies to improve receipt of education can be informed by studies that elucidate barriers to education.


E.A. Lundeen: None. I. Mendez: None. M.M. Saunders: None. J.B. Saaddine: None.

Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered. More information is available at