BMJ public health · 2026
Healthcare utilisation, diagnosed depression and anxiety among US adults with diagnosed diabetes and pre-diabetes, 2021-2023: a national cross-sectional study.
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Bardenheier Barbara H, Rodriguez Betsy, Mahajan Poonam, Zaganjor Ibrahim, Hora Israel, Bullard Kai McKeever
Аннотация
INTRODUCTION: The comorbid association of both depression and anxiety with diabetes and pre-diabetes is costly and has deleterious effects on quality of life. We report comorbid depression and anxiety prevalence by diabetes status.
RESEARCH DESIGN AND METHODS: Using the cross-sectional 2021-2023 National Health Interview Survey including 86 404 US adults aged ≥18 years with self-reported diagnosed diabetes, pre-diabetes or neither, we report crude prevalence of self-reported depression and anxiety and adjusted prevalence ratios for socio-economic status, comorbidities and healthcare utilisation stratified by diabetes status.
RESULTS: One-fourth (25.6%) of adults with diabetes, 24.6% with pre-diabetes and 16.6% with neither reported depression, while 21.1%, 22.9% and 16.6% reported anxiety, respectively. Regardless of diabetes status, prevalence of depression and anxiety was higher among non-Hispanic white adults compared with other racial and ethnic populations. Prevalence of depression and anxiety among those who missed medication due to cost was significantly associated in adults with and without diabetes (p values <0.001).
CONCLUSIONS: The prevalence of diagnosed depression and/or anxiety was similar among adults with diabetes or pre-diabetes and higher than those with neither. A substantial proportion of US adults are at risk of diabetes, diabetes complications or comorbid depression and anxiety with diabetes or pre-diabetes, but those conditions may be prevented, delayed and/or treated. Preventing cost-related medication non-adherence may improve health outcomes. Surveillance of national and state prevalence data for depression and anxiety by diabetes status may be consistently reported to inform healthcare policy and state health departments in decision-making for allocation of resources.
RESEARCH DESIGN AND METHODS: Using the cross-sectional 2021-2023 National Health Interview Survey including 86 404 US adults aged ≥18 years with self-reported diagnosed diabetes, pre-diabetes or neither, we report crude prevalence of self-reported depression and anxiety and adjusted prevalence ratios for socio-economic status, comorbidities and healthcare utilisation stratified by diabetes status.
RESULTS: One-fourth (25.6%) of adults with diabetes, 24.6% with pre-diabetes and 16.6% with neither reported depression, while 21.1%, 22.9% and 16.6% reported anxiety, respectively. Regardless of diabetes status, prevalence of depression and anxiety was higher among non-Hispanic white adults compared with other racial and ethnic populations. Prevalence of depression and anxiety among those who missed medication due to cost was significantly associated in adults with and without diabetes (p values <0.001).
CONCLUSIONS: The prevalence of diagnosed depression and/or anxiety was similar among adults with diabetes or pre-diabetes and higher than those with neither. A substantial proportion of US adults are at risk of diabetes, diabetes complications or comorbid depression and anxiety with diabetes or pre-diabetes, but those conditions may be prevented, delayed and/or treated. Preventing cost-related medication non-adherence may improve health outcomes. Surveillance of national and state prevalence data for depression and anxiety by diabetes status may be consistently reported to inform healthcare policy and state health departments in decision-making for allocation of resources.