Women with Diagnosed Diabetes across the Life Stages: Underuse of Recommended Preventive Care Services

Abstract

Diabetes is a common and costly disease. In 2007, an estimated 24 million people in the United States had diabetes, with almost half of these being women. Diabetes increases the risk of morbidity and mortality from several conditions, including cardiovascular disease, several types of cancers, influenza and pneumococcal infection, and kidney, eye, and periodontal diseases. The aim of this study was to examine the quality of care that women with diabetes receive and to assess how receipt of some clinical preventive services and screening for common conditions associated with diabetes vary according to socioeconomic factors. Our findings indicate that use of diabetes-specific preventive care among women is low, with the youngest women (< or =45 years) and those with low educational levels being the least likely to receive the recommended services. Women with diabetes were less likely than women without diabetes to receive a Pap smear, with the oldest women (> or =65 years) being the most vulnerable. Women with diabetes who were poor and nonwhite were less likely than more affluent and white women to receive a pneumococcal vaccination. This study's findings suggest that having a chronic disease may serve as a barrier to the receipt of recommended preventive care among women. Effective interventions should be designed to meet the needs of the most vulnerable women with diabetes, in particular, those who are at the extremes of the life cycle, are poor, and have low levels of education. Programs should use a life stage approach to address the unique needs of women with diabetes.

A Call to Action: Women and Peripheral Artery Disease

“…Diabetes mellitus is a well-known risk factor for PAD, and diabetes mellitus-specific preventive care among women is low. 48 In some minority populations, the interaction of biology and environment results in a higher prevalence of diabetes mellitus, more advanced PAD at presentation, and a greater proportion of minority women with PAD. 32, 49 The preponderance of chronic diseases that are influenced by diet and physical inactivity, such as type 2 diabetes mellitus, obesity, and hypertension, rather than by factors known to have a significant heritable component suggests that the disparity in risk factors is more strongly related to social determinants of disease.…”

Preventive Services Delivery in Patients With Chronic Illnesses: Parallel Opportunities Rather Than Competing Obligations

“…A 1997 study showed that patients with chronic illness were less likely to receive recommended preventive services, 3 as did a more recent report focused only on patients with diabetes mellitus. 4 In contrast, other reports have shown positive associations between chronic disease comorbidity and osteoporosis screening, 5 and between rheumatoid arthritis and dyslipidemia and osteoporosis screening. 6 …”

Exploring opportunities for colorectal cancer screening and prevention in the context of diabetes self-management: an analysis of the 2010 National Health Interview Survey

“…Some studies have found factors such as socioeconomic status, glycemic control, health insurance coverage, utilization of health services, and filling of diabetes prescriptions to be associated with CRC screening among adults with diabetes [17][18][19][20][21]. However, these studies have not examined CRC screening in relation to diabetes self-management.…”