Assessing Changes in Diabetes Management and Diabetes Complications in Utah Ladene Larsen, RN Barbara Larsen, RD, MPH William Stinner, Ph.D. Sandra Assasnik, MA Brenda Ralls, Ph.D.

The Burden of Diabetes Diabetes is the 4th leading cause of death from chronic disease Diabetes costs the nation over $100 billion annually Diabetes increases the risk of heart disease, kidney failure, blindness, and amputation

Effective Diabetes Management Can: Reduce blindness by 50% Reduce lower-extremity amputation by 50% Reduce kidney disease by 50% Reduce heart disease and stroke by 25%

Methods Surveys targeting Utahns with diabetes were conducted in 1987, 1991, and 1997 Ages ranged from 3 to 93 Over 200 respondents were included at each wave of the survey

Decreasing Age at Diagnosis of Diabetes by Gender: Utahns With Diabetes Survey, 1987, 1991 and 1997

Percent of Utahns With Diabetes Who Used Insulin:

Percent of Utahns With Diabetes Who Used Oral Meds:

Percent of Utahns with Diabetes Who Used Both Insulin and Oral Meds:

Insurance Coverage Among Utahns with Diabetes

Percent of Utahns with Diabetes Who Had Health Insurance:

Access to Provider Services Among Utahns with Diabetes Who Were Covered by Insurance:

Complications Among Utahns With Diabetes

Percent of Utahns with Diabetes with LEAs:

Percent of Utahns with Diabetes Who Were on Dialysis:

Percent of Utahns with Diabetes Who Had Diabetic Retinopathy:

Percent of Utahns with Diabetes Who Were Referred for Dilated Eye Exam:

Percent of Utahns with Diabetes Who Had High Blood Pressure:

Percent of Utahns with Diabetes With Angina:

Percent of Utahns with Diabetes, Who Had High Blood Pressure, by Age, With and Without Diabetes: Utah Health Status Survey, 1996

Percent of Utahns with Diabetes, Who Had High Cholesterol Levels, by Age, With and Without Diabetes: Utah Health Status Survey, 1996

Percent of Utahns Who Had Cardiovascular Disease, by Age, With and Without Diabetes: Utah Health Status Survey, 1996

Provider Care Among Utahns With Diabetes

Primary Care Providers for Utahns with Diabetes: Urban and Rural Areas, 1997 Urban Rural

Patient-Doctor Communication Patterns at Routine Visits for Utahns with Diabetes:

Percent of Utahns with Diabetes Who Received Provider Services During Routine Visits:

Differences at Routine Check-ups Between General or Family Practice Physicians and Internists: 1997

Differences in Doctor-Patient Communication Between General or Family Practice Physicians and Internists: 1997

Self-Management Among Utahns With Diabetes

Percent of Utahns with Diabetes Who Checked Own Feet and Glucose:

Percent of Utahns with Diabetes Who Used Meal Plan

Percent of Utahns with Diabetes Who Exercised:

Percent of Utahns with Diabetes Who Smoked:

Percent of Utahns with Diabetes Who Were Obese (BMI>=30 kg/m 2 ):

Conclusions: Age of diagnosis of diabetes is declining Use of pharmaceuticals is increasing Insurance coverage is increasing Prevalence of serious complications is increasing Quality of provider care is improving Patients are becoming more responsible for their own management of diabetes

Implications We need to provide better information on diabetes management protocol to general and family practitioners Increasing obesity may be the greatest obstruction to seeing reductions in secondary complications from diabetes and may be off-setting all the other gains made

“Diabetes is a disease about which we can do a great deal, but only when those affected are informed and empowered to take the kind of control of this disease that is now possible.” Dr. James R. Gavin III, MD Chair, African-American Program

Contact Information : Brenda Ralls Utah Diabetes Control Program Bureau of Health Promotion Utah Department of Health Salt Lake City, UT (801)