Diabetes affects nearly 21 million people in the United States. of life among people with diabetes is a crucial public health goal. …
Physical Health among Florida Adults with Diabetes
Florida Department of Health
INTRODUCTION
Diabetes affects nearly 21 million people in the United States It was the sixth leading cause of death listed on US death certificates in 2002 Maintaining and improving health-related quality of life among people with diabetes is a crucial public health goal The Behavioral Risk Factor Surveillance System BRFSS is a state-based random telephone survey of non-institutionalized adults, designed to monitor risk behaviors, chronic illness, and access to health care The BRFSS collects data on diabetes by asking respondents if they were told by a doctor that they had diabetes In 2006, Florida BRFSS surveyed 10,726 adults statewide with a response rate of 512 Among the respondents, 1,143 reported having diabetes In this report, 2006 data were used with the exception of the section on diabetes complications, which used 2005 data In 2005, Florida BRFSS surveyed 8,190 adults statewide with a response rate of 494 BRFSS survey data are adjusted, or weighted, so that the resulting estimates can be generalized to all Florida adults The purpose of this report is to compare the physical health status of
people with and without diabetes Prevalence data, risk factors related to poor physical health, and information on diabetes complications and the prevention of diabetes complications, are provided to create a more comprehensive snapshot of the burden of diabetes in Florida Poor physical health is defined as respondents who reported that their physical health was not good on 14 or more days during the past 30 days Good physical health is defined as respondents who reported that their physical health was not good on less than 14 days during the past 30 days
RESULTS
1 Prevalence of Poor Physical Health by Diabetes Status Adults with diabetes were approximately three Figure 1 Prevalence of Poor Physical Health by times more likely to have poor physical health Diabetes Status, Florida, 2006 255, than adults who did not have diabetes 30 91 Figure 1 255
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On average, adults with diabetes experienced 77 days in which their physical health was not good during the past 30 days compared to an average of three days among adults without diabetes
20
percent
15 10 5 0
91
Diabetes
Without Diabetes
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2 Prevalence of Poor Physical Health among People with Diabetes Figure 2 Compared to
their counterparts, the prevalence of poor physical health among people with diabetes was higher among: Females 35 Adults who have less than a high school education 32 People whose annual household income is less than 25,000 32 Adults who were formerly married including divorced, widowed, and separated 37 There were no significant differences in the prevalence of poor physical health among adults with diabetes by race/ethnicity, region, or age group
Figure 2 Prevalence of Poor Physical Health among People with Diabetes, Florida, 2006
50
40
P ercen t
30
20
10
0
H igh S chool H igh S chool 25,000-49,999 S om e C ollege C ollege G rade Form erly M arried 25,000 50,000 M ale Fem ale M arried
Sex
Education
Income
Marriage
3 Risk Factors and Poor Physical Health among Adults with Diabetes Figure 3 Among people with diabetes, the prevalence of poor physical health was higher among: Those who did not engage in any exercise or physical activity 38 than among those who participated in any exercise 18 Adults who ever had any sores or irritations on their feet 51 than among adults who had no feet problems 23 People who had eye problems or retinopathy 37 than among people
who had no eye problems 23 People who did not receive emotional support 34 than among people who received emotional support 21
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Figure 3 Prevalence of Poor Physical Health by Risk Factors among People with Diabetes, Florida, 2006
70 60 50 Percent 40 30 20 10 0 Without Foot Sores Retinopathy Without Retinopathy No Exercise No Support Foot Sores Exercise Received Support
Physical Activity
Foot Sores
Retinopathy
Emotional support
4 Diabetes Complications Among adults with diabetes, 621 were told by doctors that they had high blood pressure; 618 had high blood cholesterol; almost 30 had cardiovascular disease such as heart attack, coronary heart disease, or stroke; 22 had retinopathy or reported that diabetes had affected their eyes; and 94 have had sores or irritations on their feet that took more than four weeks to heal Among adults with diabetes, those who reported poor physical health were 15 times more likely to have cardiovascular disease 45, diabetes-related eye problems 344, and foot problems 15 than the total adult population with diabetes 5 Prevention of Diabetes Complications A key goal of diabetes care and treatment is to prevent diabetes complications Careful
management of diabetes and checking for early signs of complications can prevent or at least minimize complications
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DIABETES CARE
1 Self-Monitoring Daily self-monitoring of blood glucose is a vital means for managing glucose levels Adults with diabetes who also had poor physical health were significantly more likely to monitor their blood glucose daily than adults with diabetes who had good physical health 73 vs 57 Self-foot care and exam is strongly recommended at least once a week for people with diabetes Among adults with diabetes and poor physical health, 81 che 
cked their feet for any sores or irritations at least once a week, which is similar to the number 79 for adults with diabetes who had good physical health Figure 4
Figure 4 Prevention of Diabetes Complications among Adults with Diabetes and Poor Physical Health, Florida, 2006
Self Monitoring Blood for Glucose or Sugar Self Monitoring Feet for any Sores or Irritations Eye Exam in which the Pupils were Dilated
10 18 73
6
13
5 23
81
72
Check daily Check Sometimes Never Check
Check at least Once a Week Check Sometimes Never Check
Within One Year More than One Year Never Check
2 Diabetes Care by Healthcare
Provider Among adults with diabetes and who reported poor physical health: Nearly 88 had seen a health professional for diabetes in the past 12 months Nearly 73 had a health professional check for A1C in the past 12 months A1C is a measure of the average level of blood sugar over the past three months Over 72 had a health professional check their feet for any sores or irritations in the past 12 months Over 72 had an eye exam in which the pupils were dilated within one year An eye exam is strongly recommended at least once a year for diabetes patients See Figure 4 Over 85 were currently taking insulin or diabetes pills Approximately 49 had taken a course or class in how to manage diabetes The prevalence of receiving a diabetes treatment by a healthcare provider was similar between people who had poor physical health and those with good physical health
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VACCINATION
People with diabetes should receive an influenza shot once a year and a pneumonia shot once or twice in a persons lifetime Staying up-to-date on vaccinations can help avoid serious diabetes complications Among adults with diabetes, over 54 had not had a flu shot in the past 12 months, and 57 had never had a
pneumonia shot Those numbers were significantly lower than the prevalence of adults without diabetes no flu shot for 74 and no pneumonia shot for 76 Among adults with diabetes who reported poor physical health, approximately 50 had not had a flu shot in the past 12 months, and 54 had never had a pneumonia shot These numbers were similar to those for people with diabetes who reported good physical health SMOKING Heart disease and stroke are major complications of diabetes Cigarette smoking increases the risk of these diseases, particularly among people with diabetes People with diabetes should not smoke An important component of diabetes management is tobacco cessation In this report, current smokers were defined as adults who smoked at least 100 cigarettes in their entire life and smoked cigarettes on either some days or all days In 2006, over 16 of adults with diabetes reported current smoking The prevalence of current smoking was significantly lower than that among adults without diabetes 21 Among adults with diabetes and those who reported poor physical health, 24 were current smokers This was significantly higher than the prevalence of current smoking among people with
diabetes who had good physical health 14
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Appendix
Table 1 Prevalence of Poor Physical Health among Florida Adults with Diabetes, 2006 Prevalence 95 percent CI 255 220 291 Total Sex Male 184 141 228 Female 350 293 406 Race/ethnicity NHW 269 227 311 NHB 216 126 307 Hispanic 216 125 306 Age 18-44 45-64 291 233 349 65 231 184 277 Education high school 317 215 420 High school 252 193 311 Some college 315 238 392 College 151 101 201 Household Income 25,000 322 257 387 25,000-49,999 197 136 257 50,000 178 115 242 Marital Status Married 211 168 254 Divorced, widowed, separated 366 299 434 Single Region Rural 220 119 321 Urban 258 220 296 Table 2 Prevalence of Poor Physical Health among Florida Adults with Diabetes by Risk Factors, 2006 Prevalence 95 percent CI Exercise No exercise 382 316 449 Exercise 180 141 220 Body Weight Overweight or obese 254 215 293 Normal weight 241 155 327 Feet Sores or irritations Yes 514 385 622 No 228 192 264 Eye Problems Yes 368 275 460 No 232 193 271 Receiving Emotional Support No 338 255 421 Yes 212 174 249 P value less than 005 means the sample size is smaller than 30
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Table 3 Prevention of Diabetes Complications by Physical Health
Status, FL, 2006 Poor Physical Health Good Physical Health Percent 95 percent CI Percent 95 percent CI Self-monitoring Blood glucose Check per day 728 653 803 571 520 622 Check sometimes 178 118 237 328 278 378 Feet Check at least once a 810 742 877 788 746 830 week Doctors treatment Had seen a doctor 876 810 941 835 796 873 Had A one C check 729 641 818 806 763 850 Had feet check 724 648 800 706 657 755 Had an eye exam 721 643 799 750 703 797 within one year Had an eye exam more 232 160 304 183 143 223 than one year Taken insulin or 853 789 918 818 775 862 diabetes pill Taken class 491 412 571 518 467 569 Vaccination Had a flu shot 503 423 582 562 513 612 Had a pneumonia shot 539 461 618 593 544 642 Cigarette smoking Current smoking 235 160 309 142 109 189 P value less than 005 means the sample size is smaller than 30
For more information about the BRFSS, please contact: Ms Melissa Murray, MS, BRFSS Coordinator, at 8502454444, Ext 2445, or by e-mail at Melissa_Murray@dohstateflus For more information on this report, please contact Ms Bo Bonnie Yu, MA, MAS, Statistician, at 8502454444, Ext 2407, or by e-mail at Bonnie_Yu@dohstateflus
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