title: Adults with diagnosed and untreated diabetes: who are they? How can we reach them?
abstract: Untreated or undertreated diabetes can cause debilitating complications such as blindness and amputations. Information about the factors associated with diagnosed but untreated diabetes may help target efforts to promote appropriate treatment. Using the Medical Expenditure Panel Survey, we examine: (1) use of insulin or oral medications, (2) use of diet only, and (3) no treatment. We analyze covariates of this trichotomous outcome using multinomial logit regression. Among adults diagnosed with diabetes, 87.0% used oral medications or insulin, 10.6% used diet only, and 2.4% were untreated. Lacking a usual source of care, poor mental health, being single, and being an Asian/Pacific Islander are associated with lack of treatment. Better health, lacking a usual source of care, and attitudes against medical care are associated with using diet only. Adults with diagnosed but untreated or undertreated diabetes may be difficult for service providers to reach, and multiple strategies are needed to initiate treatment.
authors.affiliation: Center for Financing, Access and Cost Trends, Agency for Healthcare Research and Quality, USA. steven.hill@ahrq.hhs.gov
authors.forename: Steven C
authors.initials: SC
authors.lastname: Hill
authors.forename: G Edward
authors.initials: GE
authors.lastname: Miller
authors.forename: Merrile
authors.initials: M
authors.lastname: Sing
mesh_terms: D000328:Adult; D000368:Aged; D003920:Diabetes Mellitus / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy; D004035:Diet Therapy; D005260:Female; D019538:Health Care Surveys; D006297:Health Services Accessibility; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D007328:Insulin / Q000627:therapeutic use*; D007407:Interviews as Topic; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care; D015995:Prevalence; D012307:Risk Factors; D012931:Social Environment; D012959:Socioeconomic Factors; D014481:United States / Q000453:epidemiology
chemical_list: D007004:Hypoglycemic Agents; D007328:Insulin