Effective screening for diabetes is hindered by the health care system

Diabetes screening recommendations are based on research regarding risk factors for pre-diabetes and diabetes. Demographic, behavioral, and social factors influence this highly prevalent and debilitating condition. Behavioral Risk Factor Surveillance System data collected in 2010 from 32 states were used to demonstrate the variables that have the most impact on diagnosed diabetes among adults aged 18 to 64. Obese adults were at highest risk for reporting that they had been diagnosed with diabetes by a health care professional. Non-white race, no college education, and no leisure time physical activity were also significant predictors of a diabetes diagnosis. Health insurance status had no effect on the prevalence of diagnosed diabetes. The same data was used to demonstrate the variables that have the most impact on diabetes screening in the past three years among adults without diabetes. Health insurance status had the greatest impact on whether an adult had been screened for diabetes, followed by obesity and non-white race. Further, adults were more likely to be screened if they had some college education and participated in some physical activity. To summarize, health insurance status is the greatest predictor for diabetes screening, even though it is not a risk factor for a diabetes diagnosis. These findings are counterintuitive and show that the health care system in the U.S. is not enabling health care providers to target populations at highest risk for diabetes. Health care reforms are needed to improve screening practices and prevent health problems and expenditures arising from undiagnosed pre-diabetes and diabetes.