Codes and Frequencies
DIABETICEV identifies sample children and sample adults who had ever been diagnosed with "diabetes or sugar diabetes" by a doctor or other health professional.
The format of the questions about diabetes differed for children and adults. For children, respondents were shown a flashcard listing several chronic conditions (including diabetes) and asked, "Looking at this list, has a doctor or health professional ever told you that [person] had any of these conditions?" For adults, the question was, "Have you ever been told by a doctor or health professional that you have diabetes or sugar diabetes?" For women, the question was preceded by the phrase, "Other than during pregnancy" (to exclude cases of gestational diabetes present only during pregnancy).
The range of responses recognized also differed for children and adults. For children, responses were a dichotomous yes and no (or mentioned and not mentioned). For adults from 1997-2018, there was a third option, "Borderline." Borderline diabetes was not defined in the survey documentation, but outside sources indicate this term refers to "impaired glucose tolerance" or "impaired fasting glucose." In recent years, the term "pre-diabetes" has increasingly displaced the term "borderline diabetes." Beginning in 2019, a separate question was asked to report if a doctor or other health professional had ever told the respondent they have prediabetes or borderline diabetes (DIAPRE).
The Field Representative's Manual for 1997-2000 states, "Do not include self-diagnosed diabetes, pre-diabetes, high sugar, or any condition other than 'diabetes' or 'sugar diabetes.' Do NOT include a doctor's diagnosis of 'gestational diabetes' or diabetes present only when a woman is pregnant." These directions were not routinely read to respondents and were contradicted by the survey form itself, with its inclusion of the "borderline" option (which overlaps with "pre-diabetes" and "high sugar").
Beginning in 2001, the Manual included the following definition of diabetes: "Diabetes is a chronic disorder of carbohydrate metabolism involving insulin. Symptoms include elevated sugar in the urine and the blood, excessive urination, thirst, hunger, weight loss, and itching." This definition was not routinely shared with respondents.
Some diabetes-related variables, such as DIABETICEV, were included in the National Health Interview Survey (NHIS) every year, beginning in 1997. From 1997 forward, the NHIS included questions about age at first diagnosis of diabetes (DIABETICAGE) for adult respondents who reported a diabetes diagnosis (other than "borderline.") Similarly, beginning in 1997, the survey consistently asked whether persons ever diagnosed with diabetes were now taking insulin (INSULIN) or were now taking diabetic pills (DIAPILLS).
Other diabetes-related questions were periodically included in the survey, particularly in 1999 and 2003. The Manual for 2003 reported that the additional diabetes questions in that year were sponsored by the National Institute(s) of Health.
One group of the "periodic" diabetes questions collect further information on the time elapsed since first diagnosis of the illness. These include:
- Years since first diagnosed with diabetes (DIAYRSAGO, in 1999-2005)
- Diabetes diagnosed in past 12 months (DIAGNOSYR, in 1999)
- Months ago, within year, diabetes diagnosed (DIAGNOSYRMO, in 1999)
A second group of "periodic" diabetes variables relate to the hemoglobin A1C test, a blood test which provides information about how high an individual's blood sugar level has been over the past 3 months. These variables include:
- Ever heard of hemoglobin A1C (DIA1CKNOW in 1999, 2003)
- Number exams for A1C hemoglobin, past 12 months (DIA1CEXAMYR, in 1999, 2003)
- Last A1C hemoglobin level (DIA1CLEVEL, in 2003)
- Safe A1C hemoglobin level, according to doctor (DIA1CSAFE, in 2003)
A third group of "periodic" diabetes-related variables focus on the frequency of checking blood glucose levels. These variables include:
- Times per day check blood for glucose (DIAGLUCDAY, in 2003)
- How often check blood for glucose: Time period (DIAGLUCTP, in 2003)
- How often check blood for glucose: Number of units (DIAGLUCNO, in 2003)
A fourth group of "periodic" diabetes-related variables are concerned with the frequency of checking for foot sores. These variables include:
- Number exams for foot sores, past 12 months (DIAFTEXAMYR, in 1999, 2003)
- Times per week check feet for sores (DIAFTEXAMWK, in 2003)
- How often check feet for sores: Time period (DIAFTEXAMTP, in 2003)
- How often check feet for sores: Number of units (DIAFTEXAMNO, in 2003)
A fifth group of "periodic" diabetes-related variables relate to eye examinations and eye diseases linked to diabetes. These variables include:
- Months since last eye exam with pupils dilated (DIAEYEXAMO, in 1999, 2002-2003)
- Ever told had diabetic retinopathy (DIARETINEV, in 2002)
- Had diabetic retinopathy, past 12 months (DIARETINYR, in 2002)
The last group of "periodic" diabetes-related variables concern contact with health professionals for the treatment and management of diabetes. These variables include:
- Seeing one doctor for diabetes (DIAONEDR, in 2003)
- Number times saw doctor for diabetes, past 12 months (DIADRYRNO, in 2003)
- Number times saw nurse/dietician for diabetes, past 12 months(DIANURSYRNO, in 2003)
- Ever took class in diabetes management (DIACLASS, in 1999)
Starting in 2021, the following diabetes related variables were introduced:
- Time since A1C level checked (DIALASTA1C)
- How often individual felt overwhelmed from having diabetes (DIADISTRESS)
- Level of distress due to diabetes compared to before coronavirus pandemic (DIACVDSTRESS)
- See INSULIN for insulin related variables
Prior to 2016, respondents could report that a doctor or health professional had ever told them that they were borderline diabetic. From 2016-2018, respondents could report that a doctor or health professional had ever told them that they were either borderline diabetic or pre-diabetic. Beginning in 2019, the borderline diabetic or pre-diabetic response option was removed and respondents were asked a separate question to report if a doctor or health professional had ever told them that they were either borderline diabetic or pre-diabetic (DIAPRE).
The NHIS questionnaire was substantially redesigned in 2019 to introduce a different data collection structure and new content. For more information on changes in terminology, universes, and data collection methods beginning in 2019, please see the user note.
- 1974: Sample persons age 17+.
- 1983; 1991: Sample persons age 18+.
- 1988: All sample persons.
- 1989: Persons age 18+.
- 1993: Half of sample persons age 18+ in quarters 3 and 4 (excluded from AIDS supplement).
- 1997-2018: Sample adults age 18+ and sample children under age 18.
- 2019-2022: Sample adults age 18+ and sample children age 0-17.
- 1974, 1983, 1988-1989, 1991, 1993, 1997-2022