Phoebe Tran1, Lam Tran2, Liem Tran3. 1. Department of Chronic Disease Epidemiology, Yale University, New Haven, Connecticut, United States of America. 2. Department of Biostatistics, University of Michigan, Ann Arbor, Michigan, United States of America. 3. Department of Geography, University of Tennessee, Knoxville, Tennessee, United States of America.
Abstract
OBJECTIVE: Effects of stroke (i.e., memory loss, paralysis) may make effective diabetes care difficult which can in turn contribute to additional diabetes related complications and hospitalization. However, little is known about US post-stroke diabetes care levels. This study sought to examine diabetes care levels among US adults with diabetes by stroke status. METHODS: Using 2015-2018 Behavioral Risk Factor Surveillance System surveys, the prevalence of nonadherence with the American Diabetes Association's diabetes care measures (<1 eye exam annually, <1 foot exam annually, <1 blood glucose check daily, <2 A1C tests annually, no receipt of annual flu vaccination) was ascertained in people with diabetes by stroke status. A separate logistic regression model was run for each diabetes care measure to determine if nonadherence patterns differed by stroke status after adjustment for stroke and diabetes associated factors. RESULTS: Our study included 72,630 individuals, with 9.8% having had a stroke. Nonadherence levels varied for each diabetes care measure ranging from 20.4-42.2% for stroke survivors and 22.8-44.0% for those who had never had stroke. By stroke status, nonadherence with diabetes management measures was comparable except for stroke survivors having both a lower prevalence (30.2% versus 40.1%) and odds of nonadherence (OR: 0.73, 95% CI: 0.65, 0.82) with daily blood glucose check than those who had never had stroke. CONCLUSION: While nonadherence with diabetes management does not vary by stroke status, considerable nonadherence still exists among stroke survivors with diabetes. Additional interventions to improve diabetes care may help to reduce risk of further diabetes complications in this population.
OBJECTIVE: Effects of stroke (i.e., memory loss, paralysis) may make effective diabetes care difficult which can in turn contribute to additional diabetes related complications and hospitalization. However, little is known about US post-stroke diabetes care levels. This study sought to examine diabetes care levels among US adults with diabetes by stroke status. METHODS: Using 2015-2018 Behavioral Risk Factor Surveillance System surveys, the prevalence of nonadherence with the American Diabetes Association's diabetes care measures (<1 eye exam annually, <1 foot exam annually, <1 blood glucose check daily, <2 A1C tests annually, no receipt of annual flu vaccination) was ascertained in people with diabetes by stroke status. A separate logistic regression model was run for each diabetes care measure to determine if nonadherence patterns differed by stroke status after adjustment for stroke and diabetes associated factors. RESULTS: Our study included 72,630 individuals, with 9.8% having had a stroke. Nonadherence levels varied for each diabetes care measure ranging from 20.4-42.2% for stroke survivors and 22.8-44.0% for those who had never had stroke. By stroke status, nonadherence with diabetes management measures was comparable except for stroke survivors having both a lower prevalence (30.2% versus 40.1%) and odds of nonadherence (OR: 0.73, 95% CI: 0.65, 0.82) with daily blood glucose check than those who had never had stroke. CONCLUSION: While nonadherence with diabetes management does not vary by stroke status, considerable nonadherence still exists among stroke survivors with diabetes. Additional interventions to improve diabetes care may help to reduce risk of further diabetes complications in this population.
Authors: Rolf H H Groenwold; Ian R White; A Rogier T Donders; James R Carpenter; Douglas G Altman; Karel G M Moons Journal: CMAJ Date: 2012-02-27 Impact factor: 8.262
Authors: Aneesh B Singhal; José Biller; Mitchell S Elkind; Heather J Fullerton; Edward C Jauch; Steven J Kittner; Deborah A Levine; Steven R Levine Journal: Neurology Date: 2013-08-14 Impact factor: 9.910
Authors: Margaret A Powers; Joan Bardsley; Marjorie Cypress; Paulina Duker; Martha M Funnell; Amy Hess Fischl; Melinda D Maryniuk; Linda Siminerio; Eva Vivian Journal: J Acad Nutr Diet Date: 2015-06-05 Impact factor: 4.910
Authors: Michael Klompas; Noelle M Cocoros; John T Menchaca; Diana Erani; Ellen Hafer; Brian Herrick; Mark Josephson; Michael Lee; Michelle D Payne Weiss; Bob Zambarano; Karen R Eberhardt; Jessica Malenfant; Laura Nasuti; Thomas Land Journal: Am J Public Health Date: 2017-07-20 Impact factor: 9.308