Department of Chronic Disease Epidemiology, Yale University, 60 College Street, New Haven, CT, 06510, USA.
Department of Biostatistics, Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI, 48109, USA.
J Prim Prev. 2021 Oct;42(5):459-471. doi: 10.1007/s10935-021-00641-4. Epub 2021 Jul 12.
Diabetes is a potentially life-threatening metabolic condition that disproportionately affects US adults with a disability. Diabetes screening is key to early disease detection and prompt treatment, but it is not known whether US adults with a disability receive similar levels of diabetes screening as individuals without a disability. We compared diabetes screening levels in US adults with a disability to those without one. Using national 2017 Behavioral Risk Factor Surveillance System surveys, we determined the prevalence of diabetes screening by disability status in US adults who fall under the American Diabetes Association's recommended screening guidelines: those younger than 45 years old with a body mass index (BMI) ≥ 25 kg/m and those aged 45 years and older. We used logistic regression modelling to examine the impact of disability status on diabetes screening while adjusting for diabetes associated sociodemographic and clinical factors. In people with a disability, around 50% of those younger than 45 years old with a BMI ≥ 25 kg/m and 33% of those 45 years or older did not receive screening. In the under 45 years with a BMI ≥ 25 kg/m screening group, individuals with a disability had a slightly higher but non-significant prevalence, but a lower adjusted odds of diabetes screening compared to those without a disability. People with a disability under age 45 had a slightly lower but again non-significant prevalence but a higher adjusted odds of diabetes screening than did those without a disability who were age 45 or older. Additional interventions are needed to improve diabetes screening levels among US adults with a disability at high risk of developing diabetes as screening is a critical initial step in the diabetes management process.
糖尿病是一种潜在的危及生命的代谢疾病，在美国残疾成年人中发病率不成比例。糖尿病筛查是早期发现疾病和及时治疗的关键，但目前尚不清楚美国残疾成年人是否接受与非残疾成年人相同水平的糖尿病筛查。我们比较了美国残疾成年人和非残疾成年人的糖尿病筛查水平。我们使用 2017 年全国行为风险因素监测系统调查，根据美国糖尿病协会推荐的筛查指南，确定了符合筛查条件的美国残疾成年人中糖尿病筛查的患病率：年龄在 45 岁以下、身体质量指数（BMI）≥25kg/m2的人群和年龄在 45 岁及以上的人群。我们使用逻辑回归模型，在调整了与糖尿病相关的社会人口学和临床因素后，研究了残疾状况对糖尿病筛查的影响。在残疾人群中，大约有 50%年龄在 45 岁以下、BMI≥25kg/m2的人群和 33%年龄在 45 岁及以上的人群没有接受筛查。在 BMI≥25kg/m2且年龄在 45 岁以下的筛查人群中，残疾个体的糖尿病筛查患病率略高，但无统计学意义，但与无残疾者相比，残疾者的糖尿病筛查调整后比值比较低。年龄在 45 岁以下的残疾人群糖尿病筛查的患病率略低，但同样无统计学意义，但与年龄在 45 岁及以上且无残疾的人群相比，残疾者的糖尿病筛查调整后比值比更高。需要采取额外的干预措施来提高美国高风险残疾成年人的糖尿病筛查水平，因为筛查是糖尿病管理过程中的一个关键初始步骤。
