Racial and socioeconomic disparities in the utilization of diabetes medication: A comprehensive analysis of NHANES...

To examine the association between racial and socioeconomic health disparities and diabetes medications utilization using a nationally representative sample of the US population.

This study included 4469 diabetic patients (weighted N = 23,678,032) aged ≥20 years from the National Health and Nutrition Examination Survey (NHANES) 2011-2023. Patients were classified into four groups based on medication use: insulin only, noninsulin glucose-lowering drugs (GLDs), both, or none. Univariate, bivariate, and multinomial logistic regression analyses were performed to assess associations between medication use and health disparities. All analyses were weighted for the survey's complex, multistage design of NHANES.

Among the 4469 patients, 579 used insulin, 2411 used noninsulin GLDs, 754 used both, and 725 were untreated. Older patients had higher odds of using non-insulin GLDs (OR = 1.018, 95 % CI: 1.009-1.027) and both therapies (OR = 1.012, 95 % CI: 1.001-1.022) compared with younger adults. Males were more likely to use diabetes medications than females. Asians had higher odds of medication use, while other racial groups had lower odds than Whites. Participants with income higher income had lower odds of using both insulin and non-insulin GLDs (OR = 0.708, 95 % CI: 0.521-0.964) compared with those with lower income. Insured patients were more likely to use medications than the uninsured. Education level and marital status were not significantly associated with diabetes medication utilization.

This study identified demographic and socioeconomic differences in diabetes medication utilization among U.S. adults. Lower odds of medication use were observed among Mexican American, other Hispanic, other race group, females, and uninsured participants, as well as those with higher income, indicating potential gaps in equitable diabetes management. Targeted interventions to improve medication access and adherence among these groups are needed to promote more equitable diabetes care in the U.S.