THURS-086 - Diabetes Self-management Education Disparities: An Analysis of the 2023 Behavioral Risk Factor Surveillance System Survey

Brief Abstract Summary: This study aims to (1) determine the frequency of diabetes self-management education (DSME), (2) evaluate sociodemographic disparities in DSME, and (3) predict the factors associated with DSME among American adults with diabetes. We analyzed the 2023 Behavioral Risk Factor Surveillance System (BRFSS) data, which included adults aged 18 and older who reported being diagnosed with diabetes. We employed descriptive statistics, chi-square tests, and logistic regression for our analysis. Approximately 19% of individuals with diabetes received DSME. Disparities in DSME were observed across various sociodemographic factors. While race, sex, age, education, marital status, healthcare access, and diabetes duration were identified as predictors of receiving DSME, employment status was not significant. Strategies to enhance access to DSME should target populations where disparities have been identified, ensuring that all individuals with diabetes can access these essential services equitably.

Detailed abstract description:

Background: Diabetes is a long-term condition characterized by high blood glucose levels. The outlook for individuals with diabetes largely depends on daily self-management practices and comprehensive care activities. The American Diabetes Association (ADA) recommends diabetes self-management practices (DSMP) as an essential component of diabetes care. However, engagement in DSMP among people with diabetes is often below optimal levels. One significant barrier to participation in these practices is a lack of knowledge. Many individuals may not fully understand diabetes or the importance of self-management techniques, such as monitoring blood sugar levels, meal planning, and engaging in physical activity.
Diabetes self-care education (DSCE) gained prominence in the mid-20th century as healthcare providers recognized the importance of educating patients on managing their condition. In the 1970s, structured diabetes education programs emerged, focusing on equipping patients with the knowledge, skills, and abilities necessary for effective self-management. Organizations such as the ADA formalized these education efforts, emphasizing the significance of self-management in improving health outcomes. Over time, DSCE has evolved from focusing on knowledge and compliance to emphasizing empowerment and self-management. While DSCE is acknowledged as essential for the effective management of diabetes, it remains an area that is often understudied. This study aims to address this gap and contribute to the growing body of knowledge to optimize DSCE and enhance its effectiveness in diabetes self-management programs.

Methods: We analyzed data from the 2023 BRFSS. The study sample included adults aged 18 and older who self-reported having been diagnosed with diabetes. Sociodemographic factors included race, sex, age, education, marital status, employment status, and healthcare access.

Results: Approximately 14% of participants in the 2023 BRFSS reported having diabetes—about 19% of those received diabetes self-management education (DSME). Among those who did receive it, 23% attended in less than a year, 33% within 5 years, 14% between 5 and 10 years, and 30% more than 10 years ago. Disparities in DSME access were observed across all examined sociodemographic factors. While race, sex, age, education, marital status, healthcare access, and diabetes duration were identified as predictors for receiving DSME, employment status was not significant.

Conclusion: There is significant potential to improve the Diabetes Self-Management Education (DSME) rate for individuals with diabetes. Enhancing DSME can help prevent complications and optimize care. Strategies should focus on populations where disparities have been observed, ensuring all individuals with diabetes have equitable access to these essential services.