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We report comorbid depression and anxiety prevalence by diabetes status.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Research design and methods<\/jats:title>\n                    <jats:p>Using the cross-sectional 2021\u20132023 National Health Interview Survey including 86\u2009404 US adults aged \u226518 years with self-reported diagnosed diabetes, pre-diabetes or neither, we report crude prevalence of self-reported depression and anxiety and adjusted prevalence ratios for socio-economic status, comorbidities and healthcare utilisation stratified by diabetes status.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>One-fourth (25.6%) of adults with diabetes, 24.6% with pre-diabetes and 16.6% with neither reported depression, while 21.1%, 22.9% and 16.6% reported anxiety, respectively. Regardless of diabetes status, prevalence of depression and anxiety was higher among non-Hispanic white adults compared with other racial and ethnic populations. Prevalence of depression and anxiety among those who missed medication due to cost was significantly associated in adults with and without diabetes (p values &lt;0.001).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The prevalence of diagnosed depression and\/or anxiety was similar among adults with diabetes or pre-diabetes and higher than those with neither. A substantial proportion of US adults are at risk of diabetes, diabetes complications or comorbid depression and anxiety with diabetes or pre-diabetes, but those conditions may be prevented, delayed and\/or treated. Preventing cost-related medication non-adherence may improve health outcomes. Surveillance of national and state prevalence data for depression and anxiety by diabetes status may be consistently reported to inform healthcare policy and state health departments in decision-making for allocation of resources.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjph-2025-004311","type":"journal-article","created":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T03:11:49Z","timestamp":1781579509000},"page":"e004311","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Healthcare utilisation, diagnosed depression and anxiety among US adults with diagnosed diabetes and pre-diabetes, 2021\u20132023: a national cross-sectional study"],"prefix":"10.1136","volume":"4","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9911-235X","authenticated-orcid":false,"given":"Barbara H","family":"Bardenheier","sequence":"first","affiliation":[{"name":"Division of Diabetes Translation, Centers for Disease Control and Prevention, Atlanta, Georgia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0950-6369","authenticated-orcid":false,"given":"Betsy","family":"Rodriguez","sequence":"additional","affiliation":[{"name":"Division of Diabetes Translation, Centers for Disease Control and Prevention, Atlanta, Georgia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Poonam","family":"Mahajan","sequence":"additional","affiliation":[{"name":"Division of Diabetes Translation, Centers for Disease Control and Prevention, Atlanta, Georgia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ibrahim","family":"Zaganjor","sequence":"additional","affiliation":[{"name":"Division of Diabetes Translation, Centers for Disease Control and Prevention, Atlanta, Georgia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Israel","family":"Hora","sequence":"additional","affiliation":[{"name":"Division of Diabetes Translation, Centers for Disease Control and Prevention, Atlanta, Georgia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kai McKeever","family":"Bullard","sequence":"additional","affiliation":[{"name":"Division of Diabetes Translation, Centers for Disease Control and Prevention, Atlanta, Georgia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,6,15]]},"reference":[{"key":"2026061520100972000_4.2.e004311.1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cpr.2011.08.001"},{"key":"2026061520100972000_4.2.e004311.2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpsychores.2012.11.013"},{"key":"2026061520100972000_4.2.e004311.3","unstructured":"Centers for Disease Control and Prevention . 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