Diabetes-Related Risk Reduction
Women at High Risk for Diabetes: Access and Quality of Health Care, 2003-2006
Provider-Directed Risk Reduction
Individuals at high risk for diabetes have been shown to have an increased risk for cardiovascular disease, when compared to those not at high risk.44 For instance, at-risk adults are more likely to have cardiovascular disease risk factors, including higher mean weight, waist circumference, systolic blood pressure, and triglyceride levels, as well as a higher prevalence of hypertension.45
Blood Pressure Measurement
High blood pressure is more common among individuals at high risk for diabetes, compared to those not at high risk.46 Hypertension, defined as a systolic blood pressure of 140 mm Hg or higher or a diastolic blood pressure of 90 mm Hg or higher, is a major risk factor for cardiovascular disease. It is recommended that adults have their blood pressure checked at least once every 2 years.47
Women age 18 and over whose provider measured their blood pressure within the past 2 years, by diabetes risk status, 2003-2004

Source: National Health and Nutrition Examination Survey, 2003-2004. Appendix Table: Table 2.
- No significant differences were found between women at high risk and not at high risk for diabetes who had their blood pressure measured by a provider within the past 2 years.
Women age 18 and over whose provider measured their blood pressure within the past 2 years, by diabetes risk status and race/ethnicity, 2003/2004

Source: National Health and Nutrition Examination Survey, 2003-2004. Appendix Table: Table 2.
- In each racial/ethnic group, no significant difference was found between women at high risk and not at high risk for diabetes who reported having their blood pressure measured by a provider within the past 2 years.
- Among women at high risk for diabetes, Mexican Americans were significantly less likely than non-Hispanic whites to report having their provider measure their blood pressure within the past 2 years. No significant difference was found for non-Hispanic blacks.
- Among women not at risk, no significant differences were found by race/ethnicity.
Women age 18 and over whose provider measured their blood pressure within the past 2 years, by diabetes risk status and education, 2003-2004

Source: National Health and Nutrition Examination Survey, 2003-2004. Appendix Table: Table 3.
- At all levels of education, no significant differences were found between women at high risk and not at high risk for diabetes who had their blood pressure measured by a provider within the past 2 years.
- Women at high risk for diabetes who had more than a high school education were significantly more likely than women with lower levels of education to report having their blood pressure measured by a health care provider within the past 2 years.
- Women not at high risk for diabetes who had more than a high school education were significantly more likely than those with only a high school education to report having their blood pressure measured by a health care provider within the past 2 years.
Women age 18 and over whose provider measured their blood pressure within the past 2 years, by diabetes risk status and family income, 2003-2004

Source: National Health and Nutrition Examination Survey, 2003-2004. Appendix Table: Table 4.
- At all levels of family incomes, no significant differences were found between women at high risk and not at high risk for diabetes who had their blood pressure measured by a health care provider within the past 2 years.
- Women at high risk who were poor or near poor were significantly less likely than those who had high income to report having their provider measure their blood pressure within the past 2 years.
- Women not at high risk for diabetes who had less than high income were also significantly less likely to have their provider measure their blood pressure within the past 2 years.
Lipid Profile
Women age 18 and over who had a lipid profile in the past 2 years, by diabetes risk status, 2003-2006

Source: National Health and Nutrition Examination Survey, 2003-2006. Appendix Table: Table 2.
- No significant difference was found between women at high risk for diabetes and women not at high risk for diabetes to report having a lipid profile in the past 2 years.
Women age 18 and over who had a lipid profile in the past 2 years, by diabetes risk status and race/ethnicity, 2003-2006

Source: National Health and Nutrition Examination Survey, 2003-2006. Appendix Table: Table 2.
- Within each racial/ethnic group, no differences were found between women at high risk and not at high risk for diabetes who reported having a lipid profile in the past 2 years.
- Regardless of diabetes risk status, Mexican-American and non-Hispanic black women were significantly less likely than non-Hispanic white women to report having a lipid profile in the past 2 years.
Women age 18 and over who had a lipid profile in the past 2 years, by diabetes risk status and education, 2003-2006

Source: National Health and Nutrition Examination Survey, 2003-2006. Appendix Table: Table 3.
- Women at high risk for diabetes with more than a high school education were significantly more likely than those not at risk to have had a lipid profile in the past 2 years. No significant differences were found by diabetes risk status among women with a high school diploma or less.
- Women at high risk for diabetes with a high school diploma or less were significantly less likely than those who had more than a high school education to have had a lipid profile in the past 2 years.
- There were no significant differences by education level among women not at high risk.
Women age 18 and over who had a lipid profile in the past 2 years, by diabetes risk status and family income, 2003-2006

Source: National Health and Nutrition Examination Survey, 2003-2006. Appendix Table: Table 4.
- Women at high risk for diabetes who lived in poor families were significantly more likely than women not at high risk for diabetes to have had a lipid profile in the past 2 years. Within the other family income groups, there were no significant differences by diabetes risk status.
- Women at high risk for diabetes who lived in high-income families were significantly more likely than those who lived in families with lower incomes to report having a lipid profile in the past 2 years.
- Women not at high risk for diabetes who lived in high-income families were significantly more likely than those who lived in poor or near-poor families to report having a lipid profile in the past 2 years.
Provider Advice About Weight
Being overweight or obese is an established risk factor for diabetes. The American Diabetes Association recommends that clinicians counsel overweight or obese patients to lose 5 to 10% of their body weight and increase their physical activity to at least 150 minutes per week to reduce diabetes risk.48 Although clinician advice has been associated with adoption of healthy behaviors, only about one-third of adults at risk reported that they had received such advice in 2006.45
Obese women with high cholesterol who were given advice by provider, 2003-2006

Source: National Health and Nutrition Examination Survey, 2003-2006. Appendix Table: Table 2.
Advice about exercising for cholesterol reduction
Obese women with high cholesterol who were given advice that they should exercise for cholesterol reduction, by race/ethnicity, 2003-2006

Source: National Health and Nutrition Examination Survey, 2003-2006. Appendix Table: Table 2.
- Among obese women with high cholesterol, Mexican Americans were significantly more likely than non-Hispanic whites to be given advice that they should exercise to lower their cholesterol. No significant difference was found for non-Hispanic black women.
Obese women with high cholesterol who were given advice that they should exercise for cholesterol reduction, by education, 2003-2006

Source: National Health and Nutrition Examination Survey, 2003-2006. Appendix Table: Table 3.
- There were no significant differences by education among obese women with high cholesterol who were given advice that they should exercise for cholesterol reduction.
Obese women with high cholesterol who were given advice that they should exercise for cholesterol reduction, by family income, 2003-2006

Source: National Health and Nutrition Examination Survey, 2003-2006. Appendix Table: Table 4.
- There were no significant differences by income among obese women with high cholesterol who were given advice that they should exercise for cholesterol reduction.
Advice about eating fewer high-fat or high-cholesterol foods
Obese women with high cholesterol who were given advice about eating fewer high-fat or high-cholesterol foods, by race/ethnicity, 2003-2006

Source: National Health and Nutrition Examination Survey, 2003-2006. Appendix Table: Table 2.
- Among obese women with high cholesterol, Mexican Americans were significantly more likely than non-Hispanic whites to be given advice that they should eat fewer high-fat or high-cholesterol foods.
Obese women with high cholesterol who were given advice about eating fewer high-fat or high-cholesterol foods, by education, 2003-2006

Source: National Health and Nutrition Examination Survey, 2003-2006. Appendix Table: Table 3.
- There were no significant differences by education among obese women with high cholesterol who were given advice about eating fewer high-fat or high-cholesterol foods.
Obese women with high cholesterol who were given advice about eating fewer high-fat or high-cholesterol foods, by family income, 2003-2006

Source: National Health and Nutrition Examination Survey, 2003-2006. Appendix Table: Table 4.
- Obese women with middle income were significantly less likely than those with high income to be given advice about eating fewer high-fat or high-cholesterol foods. No significant difference was found between lower than middle-income groups and the high-income group.
Self-Care Behaviors
Numerous studies with followup periods ranging from 7 to 20 years have indicated that lifestyle modification through dietary changes and regular physical activity significantly lowers long-term diabetes risk among those with impaired glucose tolerance or prediabetes.4,25-30 However, according to the 2006 National Health Interview Survey, only 52.2% of adults with self-reported prediabetes reported trying to control or lose weight; 54.7% reported reducing fat or calories; and 48.5% reported increasing physical activity. Women were more likely than men to report engaging in each activity, and individuals of normal weight were less likely to report engaging in each activity than those who were overweight or obese.45
Physical Activity
Women age 18 and over who exercise 150 minutes/week, by diabetes risk status, 2003-2006

Source: National Health and Nutrition Examination Survey, 2003-2006. Appendix Table: Table 2.
- Women at high risk for diabetes were significantly less likely than women not at high risk for diabetes to report that they exercised 150 minutes per week.
Women age 18 and over who exercise 150 minutes/week, by diabetes risk status and race/ethnicity, 2003-2006

Source: National Health and Nutrition Examination Survey, 2003-2006. Appendix Table: Table 2.
- Among non-Hispanic whites, women at high risk for diabetes were significantly less likely than women not at high risk for diabetes to exercise 150 minutes per week. There were no significant differences by diabetes risk status in the other racial/ethnic groups.
- Among women at high risk for diabetes, the percentage of women who reported at least 150 minutes/week of exercise was not significantly different between the racial/ethnic groups. This finding was similar for women not at high risk for diabetes.
Women age 18 and over who exercise 150 minutes/week, by diabetes risk status and education, 2003-2006

Source: National Health and Nutrition Examination Survey, 2003-2006. Appendix Table: Table 3.
- Women at high risk for diabetes who had more than a high school education were significantly less likely to exercise at least 150 minutes per week than women not at high risk. No significant differences were found by diabetes risk status among those with a high school diploma or less.
- Among women at high risk for diabetes, no significant differences were found by education.
- Women not at high risk for diabetes who had not graduated from high school were significantly less likely than those who had more than a high school education to exercise at least 150 minutes per week.
Women age 18 and over who exercise 150 minutes/week, by diabetes risk status and family income, 2003-2006

Source: National Health and Nutrition Examination Survey, 2003-2006. Appendix Table: Table 4.
- Among poor and high-income groups, women at high risk for diabetes were significantly less likely than women not at high risk for diabetes to exercise for at least 150 minutes per week. There were no significant differences among near-poor and middle-income groups by diabetes risk status.
- Among women not at risk, poor women were significantly more likely than women who had high income to exercise at least 150 minutes per week. No significant differences were found by income level among women at risk.
Weight Loss
Women age 18 and over who tried to lose weight in the past 12 months, by diabetes risk status, 2003-2006

Source: National Health and Nutrition Examination Survey, 2003-2006. Appendix Table: Table 2.
- Women at high risk for diabetes were significantly more likely than women not at high risk for diabetes to have tried to lose weight in the past 12 months.
Women age 18 and over who tried to lose weight in the past 12 months, by diabetes risk status and race/ethnicity, 2003-2006

Source: National Health and Nutrition Examination Survey, 2003-2006. Appendix Table: Table 2.
- In all racial/ethnic groups, women at high risk for diabetes were significantly more likely than women not at high risk for diabetes to have tried to lose weight in the past 12 months.
- Among women at high risk for diabetes, non-Hispanic blacks and Mexican Americans were significantly less likely than non-Hispanic whites to have tried to lose weight in the past 12 months.
- Non-Hispanic black women not at high risk for diabetes were significantly less likely than non-Hispanic white women not at high risk for diabetes to have tried to lose weight in the past 12 months. No significant difference was found between Mexican-American and non-Hispanic white women who were not at high risk for diabetes.
Women age 18 and over who tried to lose weight in the past 12 months, by diabetes risk status and education, 2003-2006

Source: National Health and Nutrition Examination Survey, 2003-2006. Appendix Table: Table 3.
- At all levels of education, women at high risk for diabetes were significantly more likely than women not at high risk for diabetes to have tried to lose weight in the past 12 months.
- Women at high risk for diabetes who had a high school education or less were significantly less likely than women at high risk for diabetes who had more than a high school education to have tried to lose weight in the past year.
- Among women not at high risk, those who had less than a high school education were significantly less likely than those who had more than a high school education to have tried to lose weight in the past year.
Women age 18 and over who tried to lose weight in the past 12 months, by diabetes risk status and family income, 2003-2006

Source: National Health and Nutrition Examination Survey, 2003-2006. Appendix Table: Table 4.
- At all levels of family income, women at high risk for diabetes were significantly more likely than women not at high risk for diabetes to have tried to lose weight in the past 12 months.
- Regardless of diabetes risk status, women who lived in poor or near-poor families were significantly less likely than those who lived in high-income families to have tried to lose weight in the past 12 months.
Weight loss by exercising
Women age 18 and over who tried to lose weight by exercising in the past 12 months, by diabetes risk status, 2003-2004

Source: National Health and Nutrition Examination Survey, 2003-2004. Appendix Table: Table 2.
- Women at high risk for diabetes were significantly more likely than women not at high risk for diabetes to report that they tried to lose weight by exercising in the past 12 months.
Women age 18 and over who tried to lose weight by exercising in the past 12 months, by diabetes risk status and race/ethnicity, 2003-2006

Source: National Health and Nutrition Examination Survey, 2003-2006. Appendix Table: Table 2.
- In each racial/ethnic group, women at high risk for diabetes were significantly more likely than women not at high risk for diabetes to report that they tried to lose weight by exercising in the past 12 months.
- Among women at high risk for diabetes, Mexican-American women were significantly less likely than non-Hispanic white women to report they tried to lose weight by exercising in the past year.
- Among women not at high risk for diabetes, non-Hispanic black women were significantly less likely than non-Hispanic white women to report that they tried to lose weight by exercising in the past year. No significant difference was found for Mexican-American women.
Women age 18 and over who tried to lose weight by exercising in the past 12 months, by diabetes risk status and education, 2003-2006

Source: National Health and Nutrition Examination Survey, 2003-2006. Appendix Table: Table 3.
- Regardless of education level, women at high risk for diabetes were significantly more likely than women not at high risk for diabetes to report that they tried to lose weight by exercising in the past 12 months.
- Regardless of diabetes risk status, women with a high school education or less were significantly less likely than those with more than a high school education to report that they tried to lose weight by exercising in the past 12 months.
Women age 18 and over who tried to lose weight by exercising in the past 12 months, by diabetes risk status and family income, 2003-2006

Source: National Health and Nutrition Examination Survey, 2003-2006. Appendix Table: Table 4.
- At all levels of family income, women at high risk for diabetes were significantly more likely than women not at high risk for diabetes to report that they tried to lose weight by exercising in the past 12 months.
- Regardless of diabetes risk status, women who lived in poor or near-poor families were significantly less likely than women who lived in high-income families to report that they tried to lose weight by exercising in the past 12 months.
Weight loss by dieting
Women age 18 and over who tried to lose weight by dieting in the past 12 months, by diabetes risk status, 2003-2004

Source: National Health and Nutrition Examination Survey, 2003-2004. Appendix Table: Table 2.
- Women at high risk for diabetes were significantly more likely than women not at high risk for diabetes to report that they tried to lose weight by dieting in the past 12 months.
Women age 18 and over who tried to lose weight by dieting in the past 12 months, by diabetes risk status and race/ethnicity, 2003-2004

Source: National Health and Nutrition Examination Survey, 2003-2004. Appendix Table: Table 2.
- In each racial/ethnic group, women at high risk for diabetes were significantly more likely than women not at high risk for diabetes to report that they tried to lose weight by dieting in the past 12 months.
- Among women at risk, only Mexican Americans were significantly less likely than non-Hispanic whites to report that they tried to lose weight by dieting in the past 12 months.
- Among women not at high risk for diabetes, both non-Hispanic blacks and Mexican Americans were significantly less likely than non-Hispanic whites to report that they tried to lose weight by dieting in the past 12 months.
Women age 18 and over who tried to lose weight by dieting in the past 12 months, by diabetes risk status and education, 2003-2004

Source: National Health and Nutrition Examination Survey, 2003-2004. Appendix Table: Table 3.
- At each level of education, women at high risk for diabetes were significantly more likely than women not at high risk for diabetes to report that they tried to lose weight by dieting in the past 12 months.
- Regardless of diabetes risk status, women with a high school education or less were significantly less likely than women with higher levels of education to report that they tried to lose weight by dieting in the past 12 months.
Women age 18 and over who tried to lose weight by dieting in the past 12 months, by diabetes risk status and family income, 2003-2004

Source: National Health and Nutrition Examination Survey, 2003-2004. Appendix Table: Table 4.
- At all levels of family income, women at high risk for diabetes were significantly more likely than women not at high risk for diabetes to report that they tried to lose weight by dieting in the past 12 months.
- Regardless of diabetes risk status, women who lived in poor or near poor families were significantly less likely than women who lived in high income families to report that they tried to lose weight by dieting in the past 12 months.


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