Women With Diabetes: Quality of Health Care, 2004-2005

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Diabetes-Specific Preventive Care

Measurement of Hemoglobin A1c

Hemoglobin A1c measures the average level of blood glucose over a 3-month period. The test is performed to determine whether an individual's blood glucose is controlled. Good glycemic control is associated with the delay or prevention of diabetes complications, such as diabetic eye disease, diabetic kidney disease, and diabetic neurologic disease.^39-41

Annual Dilated Eye Examination

Diabetic retinopathy is the leading cause of new cases of blindness among U.S. adults ages 20-74.¹ Previous research has shown that proper screening, referral, and treatment for diabetic retinopathy would prevent blindness in almost half of those who become blind.⁴² The ADA recommends that adults with diabetes receive an annual dilated eye examination.³⁹

Annual Foot Examination

Approximately 50% of all nontraumatic lower extremity amputations occur in people with diabetes.⁴³ Being an older adult (age 75 and over), male, and African American increases the risk for diabetes-related lower extremity amputation.⁴³ Appropriate foot care is needed to reduce risk of morbidity and disability among people with diabetes. The American Diabetes Association (ADA) recommends that people with diabetes receive a foot exam annually.³⁹

Adults whose hemoglobin A1c level was less than 7.0% (left) or greater than 9.0% (right), 1999-2004

* An estimate was not possible for women ages 18-44.

Source: National Health and Nutrition Examination Survey, 1999-2004.

Appendix table number: Tables 12 and 13.

Overall and in each age group, no significant difference was found between women and men with diagnosed diabetes who had hemoglobin A1c levels less than 7.0%.
Overall, women with diagnosed diabetes were significantly less likely than men with diagnosed diabetes to have hemoglobin A1c levels greater than 9.0%.

Adults age 18 and over with diagnosed diabetes who had a hemoglobin A1c measurement, dilated eye examination, and foot examination in the past year, by gender, United States, 1999-2004

Bar charts show percentage of adults with diagnosed diabetes who had a hemoglobin A1c measurement (top left), dilated eye examination (top right), and foot examination (bottom left) in the past year, United States, 1999-2004. By gender, with diagnosed diabetes who had a hemoglobin A1c measurement. Women: Total, 92%; Ages 18-44, 84%; Ages 45-64, 92%; Age 65 and over, 97%. Men: Total, 92%; Ages 18-44, not given; Ages 45-64, 93%; Age 65 and over, 91%. By gender, with diagnosed diabetes who had an eye examination: Women: Total, 68%; Ages 18-44, 48%; Ages 45-64, 67%; Age 65 and over, 77%. Men: Total, 69%; Ages 18-44, 47%; Ages 45-64, 67%; Age 65 and over, 78%. By gender, with diagnosed diabetes who had a foot examination: Women: Total, 71%; Ages 18-44, 61%; Ages 45-64, 74%; Age 65 and over, 70%. Men: Total, 72%; Ages 18-44, not given; Ages 45-64, 73%; Age 65 and over, 74%. By gender, with diagnosed diabetes who received all three services: Women: Total, 46%; Ages 18-44, 32%; Ages 45-64, 58%; Age 65 and over, 46%. Men: Total, 46%; Ages 18-44, not given; Ages 45-64, 45%; Age 65 and over, 51%.

* Estimates for men ages 18-44 did not meet sample size criteria.

Key: HbA1c = hemoglobin A1c.

Source: Medical Expenditure Panel Survey, 2004.

Appendix table number: Tables 14, 15, 16, and 17.

Overall and in each age group, similar percentages of women and men with diagnosed diabetes received a hemoglobin A1c measurement, an eye examination, a foot examination, or all three services in the past year.
Less than one-third of the youngest women with diagnosed diabetes, ages 18-44, received all three services.

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