American Diabetes Association
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Trends in Preventive Care Services among U.S. Adults with Diagnosed Diabetes, 2008–2020

posted on 2023-10-16, 19:07 authored by Jacob T. Wittman,, Kai McKeever Bullard, Stephen R. Benoit

Objective: Preventive care services are important to prevent or delay complications associated with diabetes. We reported trends in receipt of six American Diabetes Association recommended preventive care services during 2008–2020.

Research Design and Methods: We used 2008–2020 data from the cross-sectional Medical Expenditures Panel Survey to calculate the proportion of U.S. adults ≥18 years of age with diagnosed diabetes that reported receiving preventive care services, overall and by subpopulation (n = 25,616). We used Joinpoint regression to identify trends during 2008–2019. The six services completed in the past year included ≥1 dental examination, dilated eye examination, foot examination, ≥2 A1C tests, cholesterol test, and receipt of an influenza vaccine.

Results: From 2008–2020, proportions of U.S. adults with diabetes receiving any individual preventive care service ranged from 32.6% to 89.9%. From 2008–2019, overall trends in preventive services among these adults were flat except for an increase in influenza vaccination (average annual percent change: 2.6% [95% CI: 1.1%, 4.2%]). Trend analysis of subgroups was heterogeneous: influenza vaccination and A1C testing showed improvements among several subgroups, while cholesterol testing (45-64 year age, < high school education, Medicaid insurance) and dental visits (uninsured) declined. In 2020, 8.2% (4.5%, 11.9%) of those with diabetes received none of the recommended preventive care services.

Conclusions: Other than influenza vaccination, we observed no improvement in preventive care service utilization among U.S. adults with diabetes. These data highlight services and specific subgroups that could be targeted to improve preventive care among adults with diabetes.


The authors report no funding sources.