Impact of a diabetes diagnosis on preventive care utilization among middle-life adults in the United States: A mediation analysis of depressive symptoms

Objective: To examine the association between diabetes diagnosis and preventive care utilization and whether depressive symptoms mediate this relationship. Methods: The study used data from four waves of the National Longitudinal Survey of Youth gathered between 2006 and 2016 (n = 6995) in the United States. Logistic regression models were used to examine the relationship between a diabetes diagnosis and preventive care utilization and whether depressive symptoms mediated this relationship. Results: After controlling for demographic, socioeconomic, and health variables, a diabetes diagnosis significantly increased preventive care utilization of blood pressure, cholesterol, blood sugar, electrocardiograph tests, and influenza vaccinations. Also, depressive symptoms mediated the association between a diabetes diagnosis and three preventive care service utilization types: influenza vaccinations, blood pressure, and electrocardiograph tests. Depressive symptoms decreased blood pressure tests and increased influenza vaccinations and electrocardiograph tests. Depressive symptoms did not mediate blood cholesterol or blood sugar tests. Conclusions: Results indicated that a diagnosis of diabetes increases the use of preventative services, with the strongest effect on blood sugar tests. However, depressive symptoms slightly reduced the utilization of blood pressure testing. Future studies need to further examine the roles of doctor's recommendations and the roles of family members and familial care.