Care for people with diabetes, who are at higher risk for disease-related blindness, limb amputations and kidney failure, has been getting worse rather than better, according to an analysis taken from the Agency for Healthcare Research and Quality's latest National Healthcare Disparities Report .
For example, the agency said, the proportion of low income adults age 40 and older with diabetes who had annual recommended blood sugar levels tested, had their eyes examined for retinopathy and their feet examined for nerve damage and circulation issues declined from 39% to 23% between 2002 and 2007.
For middle-income adults, the situation remained the same, with slightly more than half, 52%, receiving those recommended yearly exams.
Racial disparities in getting these recommended screenings was pronounced. Blacks experienced an 11 percentage point drop, from 43% to 32%. The percentage of Hispanics who had all three exams dropped from 34% to 27%. And among whites, diabetes testing also declined, but by only 4 points, from 43% to 39%.
Regardless of race or ethnicity, monitoring of complications among adult residents of large inner cities dropped from 45% to just under 33%, the agency said.
The survey found a wide gap in diabetes screening care for people depending on their level of education. For example, the percentage of adults with some college education who had the three tests dropped from 51% to 47%, but for those with just a high school education, the number fell from 43% to 32%. For those who did not finish high school, the drop was 34% to 29%.
The survey found that for middle-income adults the drop in these three tests to prevent complications from diabetes was 41percent to 33 percent, but in contrast, the proportion of high-income adults who had all three exams remained the same at 52 percent. Complications can include blindness, kidney failure, and amputation.