Disparities in Diabetes Management by Race or Ethnicity in a Primary Care Clinic in Central Texas
Tex Med. 2010;106(11):55.
By Samuel N. Forjuoh, MD, DrPH; Jane N. Bolin, RN, JD, PhD; Manisha Gupta, MD, MPH; Charles Huber, PhD; Janet W. Helduser, MA; Sonia Holleman, BS; Anne Robertson; and Marcia G. Ory, PhD, MPH
We determined the nature and magnitude of extant health disparities in patients with type 2 diabetes (T2DM) by race and ethnicity. Data were abstracted from the electronic medical records and charts of all patients 18 years and older who had been diagnosed with T2DM and seen over a 1-year period in one primary care clinic. Data abstracted included patient demographics; provision of counseling on smoking cessation, diet, exercise, and home blood glucose monitoring (HBGM); health care utilization; laboratory measures; and clinical outcomes. No significant racial or ethnic differences were found in the rate of provision of counseling on smoking cessation, diet, exercise, and HBGM, which were all suboptimal according to American Diabetes Association recommendations. In addition, no significant differences were found in the mean number of hospital admissions, emergency room visits, and referrals for specialty care. However, the mean HbA1c levels for African Americans (9.9%) and Hispanics (9.0%) were significantly higher than that of whites (8.7%; P<.0001), even after controlling for body mass index and age. Explanation of the significant racial and ethnic differences found in HbA1c levels, despite similar diabetes self-management treatment protocols or health care utilization, calls for further research.
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