Self-Management Practices Among Adults With Diabetes in the United States

An Analysis of the 2017-2020 National Health and Nutrition Examination Survey (NHANES)

Nguyen, Tran Ha DPH, MPH, MT(ASCP)SC
Barefield, Amanda EdD, RHIA, LNHA
Chandler, Lindsay MPH
De Leo, Gianluca PhD, MBA

Department of Health Management, Economics, and Policy, School of Public Health, Augusta University, Augusta, Georgia
Department of Health Professions, College of Allied Health Sciences, Augusta University, Augusta
Department of Health Management, Economics, and Policy, School of Public Health, Augusta University, Augusta, Georgia
Department of Health Management, Economics, and Policy, School of Public Health, Augusta University, Augusta, Georgia

Tran Ha Nguyen, School of Public Health, Department of Health Management, Economics, and Policy, Augusta University, 1120 15th Street, SCI-E1019, Augusta, GA 30912, USA. Email: [email protected]

The Science of Diabetes Self-Management and Care 51(1):p 9-23, February 2025. | DOI: 10.1177/26350106241306075

Purpose

The purpose of the study was to examine the extent to which adults with diabetes engage in self-management practices to lower their blood glucose levels and determine factors associated with these engagements.

Methods

The study analyzed data from the 2017-2020 National Health and Nutrition Examination Survey (NHANES). The sample included 1171 adults ages 20 and older with a laboratory A1C level of 6.5% or greater. The statistical analyses used included descriptive, chi-square, and logistic regression.

Results

The study revealed that 36% of participants used insulin, and 28% visited a diabetes specialist yearly. Additionally, 68% took medication to lower blood glucose, and 65% monitored their blood glucose daily. Although 86% checked their A1C level annually, only 14% adhered to a diabetes diet plan. A small percentage of respondents (11%) reported engaging in recreational activities at least 5 days a week. The engagement of American adults with diabetes in self-management practices is associated, to varying extents, with the type of diabetes diagnosis, diabetes status, and social determinants of health in adults with diabetes.

Conclusion

The recommended self-management practices among adults with diabetes in the United States are not fully embraced and are associated with several factors. Study findings also indicated that the numbers of undiagnosed and dated-diagnosed diabetes as prediabetes continue to be a problem.