Evidence map›Paper›PMID 40439815›Full record

ArticleDiabetes therapy : research, treatment and education of diabetes and related disorders2025

Association Between Diabetes Management Behaviors and State-Level Social Vulnerability: A Cross-sectional Study.

Debra Winberg, Nicolas Marchi, Tiange Tang, Lizheng Shi

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Article in Diabetes therapy : research, treatment and education of diabetes and related disorders, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

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2citing papers in PubMed
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3 · Its place in the literature

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2 citing papers in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

4 authors.

Debra WinbergDepartment of Health Policy and Management, Tulane University Celia Scott Weatherhead School of Public Health and Tropical Medicine, 1440 Canal St, Suite 1900, New Orleans, LA, 70112, USA. dwinberg@tulane.edu.ORCID http://orcid.org/0000-0003-2909-1455
Nicolas MarchiUniversity Hospitals Plymouth NHS Trust, Derriford Road, Crownhill, Plymouth, Devon, PL6 8DH, UK.
Tiange TangDepartment of Health Policy and Management, Tulane University Celia Scott Weatherhead School of Public Health and Tropical Medicine, 1440 Canal St, Suite 1900, New Orleans, LA, 70112, USA.
Lizheng ShiDepartment of Health Policy and Management, Tulane University Celia Scott Weatherhead School of Public Health and Tropical Medicine, 1440 Canal St, Suite 1900, New Orleans, LA, 70112, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionType 2 diabetes mellitus remains a major public health concern in the United States. Previous research demonstrates that social determinants of health, including inequities in living conditions, directly affect the biological and behavioral outcomes associated with diabetes control and prevention. New tools such as the social vulnerability index (SVI) can be used to assess these inequities. This paper aims to assess the impact of state-level social vulnerability on diabetes management behaviors.

methodsWe used data from the Centers for Disease Control/Agency for Toxic Substances and Disease Registry's Social Vulnerability Index (SVI) and the Behavioral Risk Factor Surveillance System (BRFFS) Survey. The final sample included data from 2016 to 2021 and 89,643 people diagnosed with type 2 diabetes. We averaged the SVI and its component indices for each state and categorized them into terciles. The outcome measures included whether the respondents received diabetes education, conducted self-monitoring of blood glucose levels, and received medical care for diabetes. We ran logistic regressions to test the impact of the SVI on the outcomes, adjusting for state and fixed time-fixed effects and covariates. We weighted according to BRFFS guidelines.

resultsIndividuals in states with moderate social vulnerability were 1.87 times more likely to receive diabetes education than those in states with the lowest vulnerability (p < 0.01). Conversely, those in states with the highest vulnerability were 1.48 times more likely to see a doctor for diabetes care than those in the least vulnerable states (p =  < 0.01). However, individuals in states with moderate vulnerability are less likely to self-monitor their blood sugar levels (OR = 0.74, p = 0.03).

conclusionsPeople in states with different levels of social vulnerability exhibit differences in behaviors affecting diabetes management, particularly in activities not captured by standard diabetes quality measures. Differences are more apparent in activities that are not part of diabetes quality measures.

Indexed as

BehaviorsDiabetesDisparitiesManagementPreventionSDoH social vulnerabilitySVI

Identifiers

PMID40439815
PMCPMC12182532

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.