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Codes and Frequencies

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INSULIN reports responses to the question, "Are you now taking insulin?" The U.S. Food and Drug Administration website on diabetes information notes that insulin is taken by diabetics to control blood sugar levels and that insulin cannot be taken by mouth because it would be destroyed by digestion. Instead, insulin is injected through shots or other devices such as insulin pens, jet injectors, or pumps.

Respondents who received the question associated with INSULIN were also asked if they were currently taking diabetic pills, also called oral agents or oral hypoglycemic agents, to lower their blood sugar (DIAPILLS).

Related Variables
Starting in 2021, the following diabetes related variables were introduced:

  • Delayed buying insulin, past 12m (DELAYINSL)
  • Took less insulin, past 12m (LESSINSL)


Apart from universe changes and major questionnaire changes introduced in 2019, the INSULIN variable is largely comparable over time.

Universe Changes 

In 1976, diabetic patients were first asked if they had ever taken insulin. Participants who responded "yes" (INSULINEV = 2) were then asked if they are now taking insulin. In 1989, this question was asked of persons ages 18 and older who have confirmed diabetes.

In 1997-2005, the question for INSULIN was asked of sample adults who were ever told by a doctor or other health professional that they had diabetes (other than during pregnancy) (DIABETICEV). In 2006, the question was asked of all sample adults. The 2006 Field Representative's Manual provides the following explanation for the universe change put in place that year:

Because medical care is changing to prevent diabetes, NIDDK [National Institute of Diabetes and Digestive and Kidney Disease] wants to assess the use of diabetes medications by people not yet diagnosed with diabetes. Therefore, all sample adults, regardless of whether they have been diagnosed with diabetes, will be asked whether they NOW take insulin and whether they NOW take diabetic pills.

Starting in 2007, the universe for INSULIN was redefined to cover sample adults who had ever been told they had diabetes (other than during pregnancy) or that they had a prediabetic condition, including prediabetes, impaired fasting glucose tolerance, borderline diabetes, or high blood sugar (DIAPRECOND).

Questionnaire design changes introduced in 2019 limit comparability with earlier years. 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.


  • 1976: Persons with some type of diabetes who have ever taken insulin injections.
  • 1981: Sample persons under age 18 who were ever hospitalized overnight (not including when born) and were treated for diabetes during hospitalization.
  • 1989: Persons age 18+ who have ever been told by a doctor they had diabetes (other than during pregnancy)
  • 1991: Sample persons age 18+ who were ever told they had diabetes (other than during pregnancy).
  • 1997-2005: Sample adults age 18+ who were ever told they had diabetes (other than during pregnancy).
  • 2006: Sample adults age 18+.
  • 2007-2018: Sample adults age 18+ who were ever told they had diabetes or a prediabetic condition (other than during pregnancy).
  • 2019-2022: Sample adults age 18+ who were ever told they had diabetes or prediabetes (except gestational diabetes).


  • 1976, 1981, 1989, 1991, 1997-2022