Data & Trends

Diabetes Surveillance System

1999 Surveillance Report

Persons with diabetes are at increased risk for serious health complications such as blindness, kidney failure, non-traumatic lower-extremity amputations, and cardiovascular disease. Preventive care practices, such as routine dilated-eye and foot examinations, self-monitoring of blood glucose, glycemic control, and influenza and pneumococcal vaccinations, have been shown to be effective in reducing both the incidence and progression of diabetes-related complications (28-33). It is currently recommended for persons with diabetes to receive an annual dilated-eye exam, receive an annual foot exam, perform daily self-monitoring of blood glucose, receive an annual glycosylated hemoglobin measurement, receive an annual influenza vaccine, and receive a pneumococcal vaccine. Despite the effectiveness and benefits that can be gained from these preventive care practices, this report shows the prevalence of these preventive care practices are suboptimal and there is poor compliance with national health recommendations (34).

In 1997, 61.6 % of persons with diabetes in 41 states reported receiving a dilated-eye examination within the last year, 54.6% reported receiving a foot examination within the last year, 18.4% reported having their glycosylated hemoglobin checked within the last year, 39.6% reported self-monitoring their blood glucose at least once per day, 51.5% reported receiving an influenza vaccine within the last year, and 31.8% reported ever receiving a pneumococcal vaccine (Figure 10.1; Tables 10.1, 10.2, 10.3). Receipt of the preventive care practices varied by socio-demographic characteristics. Non-Hispanic whites were more likely to receive the influenza and pneumococcal vaccinations in comparison to non-Hispanic blacks and Hispanics (Table 10.3). Men were more likely than women to have their feet examined (Table 10.1). Persons who were at least 65 years old were more likely to receive a dilated-eye exam, foot exam, and influenza and pneumococcal vaccines (Tables 10.1 & 10.3). Persons under the age of 65 were more likely to have had a glycosylated hemoglobin measurement and to self-monitor their blood glucose (Table 10.2). Individuals with at least a high school education were more likely to report receipt of most of the preventive care practices (Tables 10.1, 10.2, 10.3)

In 1997, the prevalence of preventive care practices varied by state and in general, the rates were lowest in the southeast and higher in the north (Figures 10.2c, 10.3c, 10.4c, 10.5c, 10.6c, 10.7c). Between 1995-1997, there were favorable upward trends in several states in the proportion of persons who received a dilated-eye exam and the proportion of persons who received influenza and pneumococcal vaccinations (Figures 10.2a, 10.2b, 10.2c, 10.3a, 10.3b, 10.3c, 10.4a, 10.4b, 10.4c, 10.5a, 10.5b, 10.5c, 10.6a, 10.6b, 10.6c, 10.7a, 10.7b, 10.7c). In addition, self-monitoring of blood glucose has improved in the west and midwest between the years 1995-1997 (Figures 10.5a, 10.5b, 10.5c).

Acknowledgement: The present work was supported by the Council of State and Territorial Epidemiologists (CSTE).

28. Allen TB, DeLong ER, Feussner JR. Impact of glucose self-monitoring on non-insulin treated patients with type II diabetes mellitus. Diabetes Care 1990;13:1044-1050.
29. The Diabetes Control and Complications Trial Research Group. The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin-dependent diabetes mellitus. N Engl J Med 1993;329:977-986.
30. Litzelmman DK, Slemenda CW, Langefeld CD, Hays LM, Welch MA, Bild DE, Ford ES, Vinicor F. Reduction of lower extremity clinical abnormalities in patients with non-insulin dependent diabetes mellitus. Ann Intern Med 1993;119:36-41.
31. Ferris FL. How effective are treatments for diabetic retinopathy? JAMA 1993;269:1290-1291.
32. Nichol KL, Lind A, Margolis KL, Murdoch M, McFadden R, Hauge M, Magnan S, Drake M. The effectiveness of vaccination against influenza in healthy, working adults. N Engl J Med 1995;333:889-893.
33. Nichol K, Margolis K, Wuorenma J, Von Sternberg T. The efficacy and cost effectiveness of vaccination against influenza among elderly persons living in the community. N Engl J Med 1994;331:778-784.
34. U.S. Department of Health and Human Services. Healthy People 2010 (Conference edition, in two volumes). Washington: U.S. Department of Health and Human Services, 2000.

Return to Chapter 10 Contents

Privacy Policy | Accessibility

Home | About the Program | Site Map | Contact Us

CDC Home | Search | Health Topics A-Z

This page last reviewed January 18, 2005.

United States Department of Health and Human Services
Centers for Disease Control and Prevention
National Center for Chronic Disease Prevention and Health Promotion
Division of Diabetes Translation