Factors Associated with Non-Adherence to Blood Glucose Testing Among Non-Hispanic Black and Hispanic Men with a History of Prediabetes in the United States

Introduction: Rates of prediabetes are rising in the United States, especially within communities of color. Without adopting self-care behaviors and adhering to routine screenings, prediabetes is likely to progress to type 2 diabetes. This study examines factors associated with non-adherence to recommended blood glucose testing among non-Hispanic Black and Hispanic men ages ≥ 40 years with a history of prediabetes. Methods: Using an internet-delivered survey, data were collected from 769 Black (56.7%) and Hispanic (43.3%) men with a history of prediabetes. Chi-square tests and independent sample-tests were to identify differences across study variables by race/ethnicity and blood glucose testing adherence. A logistic regression model with backward stepwise entry was fitted to assess factors associated with blood glucose testing non-adherence, adjusted for sociodemographic factors, co-morbidities, healthcare interactions, social support, and lifestyle behaviors. Results: Approximately 11% of participants did not receive a blood glucose test in the past 12 months, and 60.9% self-reported progression from prediabetes to diabetes. Men who self-reported progressing from prediabetes to diabetes were less likely to be non-adherent to blood glucose testing recommendations (Odds Ratio [OR]=0.51, P=0.006). Each additional year of age was associated with lower odds of being non-adherent to blood glucose testing (OR=0.97, P=0.018). On average, men who engaged more with healthcare providers during visits had lower odds of being non-adherent to blood glucose testing (OR=0.87, P< 0.001). Men who reported reasons for medication non-adherence (OR=1.68, P=0.043) and used tobacco products (OR=2.39, P< 0.001) were more likely to report blood glucose testing non-adherence. Conclusion: Findings suggest that disease progression, greater engagement with healthcare providers, and improved healthy behaviors may be associated with adherence to blood glucose testing among Black and Hispanic men with a history of prediabetes. Culturally tailored interventions and strategies are needed to improve adherence among male these sub-groups. Plain Language Summary: Without adopting self-care behaviors and adhering to recommended screenings, prediabetes is likely to progress to type 2 diabetes. This study examined factors associated with non-adherence to recommended blood glucose testing among non-Hispanic Black and Hispanic men ages ≥ 40 years with a history of prediabetes. Findings highlight the importance of quality of patient-provider communication and improved healthy behaviors to increase adherence to blood glucose testing among Black and Hispanic men with prediabetes.