OBJECTIVE - To estimate the levels of use of preventive care and to id
entify correlates of such care among people with diabetes in the U.S.
RESEARCH DESIGN AND METHODS - A cross-sectional study was conducted us
ing a sample of 2,118 adults, age greater than or equal to 18 years, w
ith self-reported diabetes in 22 states that participated in the 1994
Behavioral Risk Factor Surveillance System. Most subjects were age gre
ater than or equal to 45 years (83%), women (51%), and white (75%) and
were diagnosed at ages greater than or equal to 30 years (83%), had t
ype 2 diabetes (89%), and mere not using insulin (66%). RESULTS - Amon
g all people with diabetes, 78% practiced self-monitoring of blood glu
cose, and 25% were aware of the term ''glycosylated hemoglobin'' or ''
hemoglobin A one C'' (HbA(1c)). In the last year, 72% of the subjects
visited a health care provider for diabetes care at least once, 61% ha
d their feet inspected at least once, and 61% received a dilated eye e
xamination. Controlled for age and sex, the odds ratios (ORs) for insu
lin use were for self-monitoring (OR [95% CI]; 4.0 [2.6-6.1]); having
heard of HbA(1c) or receipt of a dilated eye examination (1.9 [1.4-2.5
]); at least one visit to a provider (3.4 [1.9-7.2]); and feet inspect
ed at least once (2.1 [1.5-2.9]). In addition, people <45 years, those
who did not complete high school, and those without insurance coverag
e were high-risk groups for underuse of preventive care. Only 3% of in
sulin users and 1% of nonusers met all five of the American Diabetes A
ssociation standards in the previous year. CONCLUSIONS - Underuse of r
ecommended preventive care practices is common among people with diabe
tes.