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BMJ Open. 2018 Jul 11;8(7):e017937. doi: 10.1136/bmjopen-2017-017937.

Gaps in health behaviours and use of preventive services between patients with diabetes and the general population: a population-based cross-sectional study.

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Department of Family Medicine, Myongji Hospital, Seoul, The Republic of Korea.
Department of Biostatistics, Graduate School of Public Health, Yonsei University, Seoul, The Republic of Korea.
Department of Family Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, The Republic of Korea.



Although both the prevalence and treatment rate of diabetes have increased, the degree of adherence to healthy behaviours by patients with diabetes has not yet been comprehensively evaluated. This study examines the differences in health management and mental health status according to diabetes status and awareness of that diagnosis.


This was a cross-sectional study of 14 655 people using data from the Korean National Health and Nutrition Examination Study 2010-2012, which used sampling weights. Multiple logistic regression analyses were used to compare health-risk behaviours, preventive healthcare utilisation and mental health status according to diabetes diagnosis and awareness of the disease.


Compared with people without diabetes, people with diabetes had comparably worse smoking status (adjusted OR (aOR) 1.09, 95% CI 0.92 to 1.30), insufficient physical activity (aOR 1.09, 95% CI 0.95 to 1.24) and were less likely to receive cancer screenings and regular health check-ups (aOR 0.75, 95% CI 0.66 to 0.85). Furthermore, compared with people unaware of their diabetes, people aware of their diabetes had lower odds of physical inactivity (aOR 0.66, 95% CI 0.45 to 0.99) and greater odds of receiving colon cancer screening (aOR 1.55, 95% CI 1.17 to 2.05) and influenza vaccination (aOR 1.56, 95% CI 1.15 to 2.11).


People with diabetes were no better in terms of health behaviours and preventive healthcare utilisation than those who were without diabetes. Further efforts and political attention to ensure the delivery of quality care for people with diabetes are needed.


awareness; cancer screening; diabetes; health behavior; mental health

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