This study was performed to identify factors associated with screening for diabetic retinopathy and nephropathy. Data from the Korean National Health and Nutrition Examination Survey between 2007 and 2009 were analyzed. Of 24,871 participants, 1,288 patients diagnosed with diabetes at ≥30 years of age were included. 36.3% received screening for diabetic retinopathy, and 40.5% received screening for diabetic nephropathy during the previous year. Patients living in rural areas, those with less education, those who had not received education about diabetes care, and those who did not receive medical care for diabetes were screened less often for retinopathy or nephropathy. Patients with poorer self-reported health status were screened more often. Occupation, smoking status, and diabetes duration were associated with retinopathy screening. Lower family income was associated with decreased nephropathy screening. Receiving education about diabetes care and receiving medical care for diabetes were significant factors in patients with a shorter duration of diabetes (the significant odds ratio [OR] of not receiving education varied between 0.27 and 0.51, and that of not receiving medical care varied between 0.34 and 0.42). Sociodemographic factors and health-related factors as well as education and medical care influenced screening for diabetic complications among those with a longer duration of diabetes (for retinopathy and nephropathy, the significant OR of living in a rural area varied between 0.56 and 0.61; for retinopathy, the significant OR of current smokers was 0.55, and the p-trend of subjective health status was <0.001; for nephropathy, the significant OR of a monthly household income of <3000 dollars was 0.61 and the p-trends of education and subjective health status were 0.030 and 0.007, respectively). Efforts to decrease sociodemographic disparities should be combined with education about diabetes care to increase the screening, especially for those with a longer duration of diabetes.
Choi YJ, Kim HC, Kim HM, Park SW, Kim J, et al. (2009) Prevalence and management of diabetes in Korean adults: Korea National Health and Nutrition Examination Surveys 1998–2005. Diabetes Care 32: 2016–2020.
Kim TH, Chun KH, Kim HJ, Han SJ, Kim DJ, et al. (2012) Direct medical costs for patients with type 2 diabetes and related complications: a prospective cohort study based on the Korean National Diabetes Program. J Korean Med Sci 27: 876–882.
O'Brien JA, Patrick AR, Caro J (2003) Estimates of direct medical costs for microvascular and macrovascular complications resulting from type 2 diabetes mellitus in the United States in 2000. Clin Ther 25: 1017–1038.
Adler AI, Stevens RJ, Manley SE, Bilous RW, Cull CA, et al. (2003) Development and progression of nephropathy in type 2 diabetes: the United Kingdom Prospective Diabetes Study (UKPDS 64). Kidney Int 63: 225–232.
Do YK, Eggleston KN (2011) Educational disparities in quality of diabetes care in a universal health insurance system: evidence from the 2005 Korea National Health and Nutrition Examination Survey. Int J Qual Health Care 23: 397–404.
Yoon JY, Park HA, Kang JH, Kim KW, Hur YI, et al. (2012) Prevalence of dietary supplement use in Korean children and adolescents: insights from Korea National Health and Nutrition Examination Survey 2007–2009. J Korean Med Sci 27: 512–517.
Lee YH, Bang H, Kim HC, Kim HM, Park SW, et al. (2012) A simple screening score for diabetes for the Korean population: development, validation, and comparison with other scores. Diabetes Care 35: 1723–1730.
Shin KH, Chi MJ (2009) Fundus Examination Rate in Diabetics and the Public Health Factors Associated With Fundus Examination Rate. J Korean Ophthalmol Soc AID - 103341/jkos20095091319 [doi] 50: 1319–1325.
Tapp RJ, Zimmet PZ, Harper CA, de Courten MP, Balkau B, et al. (2004) Diabetes care in an Australian population: frequency of screening examinations for eye and foot complications of diabetes. Diabetes Care 27: 688–693.
Muller A, Lamoureux E, Bullen C, Keeffe JE (2006) Factors associated with regular eye examinations in people with diabetes: results from the Victorian Population Health Survey. Optom Vis Sci 83: 96–101.
Brown AF, Gregg EW, Stevens MR, Karter AJ, Weinberger M, et al. (2005) Race, ethnicity, socioeconomic position, and quality of care for adults with diabetes enrolled in managed care: the Translating Research Into Action for Diabetes (TRIAD) study. Diabetes Care 28: 2864–2870.
Mangione CM, Gerzoff RB, Williamson DF, Steers WN, Kerr EA, et al. (2006) The association between quality of care and the intensity of diabetes disease management programs. Ann Intern Med 145: 107–116.