The impact of access to health services on prediabetes awareness: A population-based study.
Level 4 - case-series / case-control
Cross-sectional survey analysis
PubMed 27612580 · doi:10.1016/j.ypmed.2016.09.008
What was done
This cross-sectional study analyzed data from 2,999 U.S. adults with prediabetes across three cycles (2007–2008, 2009–2010, and 2011–2012) of the National Health and Nutrition Examination Survey (NHANES). Healthcare access was classified as full, partial, or none based on health insurance status and having a routine place for medical care. Multivariable logistic regression was used to evaluate the association between access levels and prediabetes awareness.
What was found
An estimated 92.0% of adults with prediabetes were unaware of their condition. Unaware participants were generally younger, male, and less likely to be obese or report a family history of diabetes. Having no healthcare access significantly increased the odds of prediabetes unawareness (AOR: 2.65; 95% CI: 1.10–6.38). However, individuals who had insurance coverage but lacked a routine place of care had the highest odds of being unaware (AOR: 3.21; 95% CI: 1.21–8.55).
Why it matters
Health insurance alone may not guarantee screening or diagnosis of prediabetes; maintaining a routine source of care is essential for identifying early metabolic risk and initiating preventive behaviors.
Limits
The cross-sectional design cannot establish causality. Awareness and healthcare utilization were based on self-reported survey measures subject to recall and reporting bias. The abstract does not report specific clinical encounter details, visit frequencies, or physician screening practices.
Cited by
- supports Approximately 90 percent of metabolic disease cases have not been diagnosed by typical healthcare providers.