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Open AccessArticle

Health Insurance Is Associated with Decreased Odds for Undiagnosed Prediabetes and Type 2 Diabetes in American Adults

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Department of Health, Nutrition, and Exercise Sciences, North Dakota State University, Fargo, ND 58108, USA
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School of Nursing, University of Michigan, Ann Arbor, MI 48109, USA
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Centre for Molecular Medicine & Innovative Therapeutics, Murdoch University, 6150 Perth, Australia
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Author to whom correspondence should be addressed.
Int. J. Environ. Res. Public Health 2020, 17(13), 4706; https://doi.org/10.3390/ijerph17134706
Received: 7 April 2020 / Revised: 21 June 2020 / Accepted: 27 June 2020 / Published: 30 June 2020
Over a third of adults in the United States have prediabetes, and many of those with prediabetes will progress to type 2 diabetes within 3–5 years. Health insurance status may factor into a proper diagnosis of prediabetes and diabetes. This study sought to determine the associations between health insurance and undiagnosed prediabetes and diabetes in a national sample of American adults. Publicly available data from 13,029 adults aged 18–64 years from the 2005–2016 waves of the National Health and Nutrition Examination Survey were analyzed. Health insurance type (Medicaid, Private, Other, None) was self-reported. Prediabetes and diabetes status were assessed with measures of self-report, glycohemoglobin, fasting plasma glucose, and two-hour glucose. Covariate-adjusted logistic models were used for the analyses. Overall, 5976 (45.8%) participants had undiagnosed prediabetes, while 897 (6.8%) had undiagnosed diabetes. Having health insurance was associated with decreased odds ratios for undiagnosed prediabetes: 0.87 (95% confidence interval (CI: 0.79, 0.95)) for private insurance, 0.84 (CI: 0.73, 0.95) for other insurance, and 0.78 (CI: 0.67, 0.90) for Medicaid. Moreover, having private health insurance was associated with 0.82 (CI: 0.67, 0.99) decreased odds for undiagnosed diabetes. Health insurance coverage and screening opportunities for uninsured individuals may reduce prediabetes and diabetes misclassifications. View Full-Text
Keywords: delivery of healthcare; healthcare disparities; mandatory testing; socioeconomic factors delivery of healthcare; healthcare disparities; mandatory testing; socioeconomic factors
MDPI and ACS Style

Mahoney, S.; Bradley, A.; Pitts, L.; Waletzko, S.; Robinson-Lane, S.G.; Fairchild, T.; Terbizan, D.J.; McGrath, R. Health Insurance Is Associated with Decreased Odds for Undiagnosed Prediabetes and Type 2 Diabetes in American Adults. Int. J. Environ. Res. Public Health 2020, 17, 4706.

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