Self-Management Practices Among Adults With Diabetes in the United States: An Analysis of the 2017-2020 National Health and Nutrition Examination Survey (NHANES)

Sci Diabetes Self Manag Care. 2025 Jan 18:26350106241306075. doi: 10.1177/26350106241306075. Online ahead of print.

Abstract

Purpose: The purpose of the study was to examine the extent to which adults with diabetes engage in self-management practices to lower their blood glucose levels and determine factors associated with these engagements.

Methods: The study analyzed data from the 2017-2020 National Health and Nutrition Examination Survey (NHANES). The sample included 1171 adults ages 20 and older with a laboratory A1C level of 6.5% or greater. The statistical analyses used included descriptive, chi-square, and logistic regression.

Results: The study revealed that 36% of participants used insulin, and 28% visited a diabetes specialist yearly. Additionally, 68% took medication to lower blood glucose, and 65% monitored their blood glucose daily. Although 86% checked their A1C level annually, only 14% adhered to a diabetes diet plan. A small percentage of respondents (11%) reported engaging in recreational activities at least 5 days a week. The engagement of American adults with diabetes in self-management practices is associated, to varying extents, with the type of diabetes diagnosis, diabetes status, and social determinants of health in adults with diabetes.

Conclusion: The recommended self-management practices among adults with diabetes in the United States are not fully embraced and are associated with several factors. Study findings also indicated that the numbers of undiagnosed and dated-diagnosed diabetes as prediabetes continue to be a problem.