PHS50 - The impact of receiving diabetes self-management education (DSME) on preventive care practices among type-2 diabetes adults

Abstract

DSME is a critical element of care for diabetes patients, leading to better outcomes. Given that one of the objectives of DSME is to prevent diabetic complications (retinopathy, limb amputation, etc.), we examine the impact of DSME on preventive care practices among type II diabetes adults. Self-reported weighted data of 2,175,315 non-institutionalized type II diabetic adults who reported DSME and seven preventive care practices was used from 2010 Behavioral Risk Factors Surveillance System (BRFSS). The preventive care practices studied were bi-annual HbA1c testing, annual dilated eye examination, daily Self-Monitoring of Blood Glucose (SMBG), annual foot examination, annual flu shot, once-in-life pneumonia vaccine and annual doctor visit. Bivariate analyses and multivariate logistic regression were performed using SAS ® 9.2. Approximately 57% (n=1,183,476) of type II diabetes adults received DSME. Receiving DSME significantly increased the likelihood of obtaining all preventive care practices except bi-annual HbA1c test (p=0.168). After adjusting for covariates, those who received DSME had higher likelihood of obtaining annual dilated eye examination (OR=1.56, 95% CI=1.27-1.92, p<0.001), daily SMBG (OR=1.59, 95% CI=1.31-1.95, p<0.001), annual foot examination (OR=2.28, 95% CI=1.84-2.81, p<0.001), annual flu shot (OR=1.27, 95% CI=1.04-1.55, p=0.019), pneumonia vaccine (OR=1.49, 95% CI=1.22-1.82, p=0.001) and annual doctor visit (OR=1.44, 95% CI=1.07-1.93, p=0.016). Hispanic ethnicity/race, males, unmarried adults, low income (less than $15,000), less than high school education and non-insulin users faced barriers to receive DSME. Having received DSME had positive impact on attainment of preventive care practices. Interventions focusing on promoting DSME and overcoming the barriers of DSME should be designed.