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Racial/ethnic differences in multiple diabetes outcomes in patients with type 2 diabetes in the southeastern United States.

Lynch CP, Williams JL, Reid J, Joseph R, Keith B, Egede LE. Racial/ethnic differences in multiple diabetes outcomes in patients with type 2 diabetes in the southeastern United States. Ethnicity & disease. 2014 Jan 1; 24(2):189-94.

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Abstract:

OBJECTIVE: To determine racial/ethnic differences in control of multiple diabetes outcomes in a large, diverse primary care sample. METHODS: 661 adults with type 2 diabetes (T2DM) were recruited from three primary care settings. The primary outcomes were individual and composite control of multiple diabetes outcomes. Control of individual diabetes outcomes were defined as hemoglobin A1c (HbA1c) < 7%, blood pressure (BP) < 130/80 mmHg and low-density lipoprotein (LDL)-cholesterol < 100 mg/dL. Composite control was defined as having all three outcomes under control. Linear and logistic regression models were used to assess differences in individual means and individual and composite outcomes control between non-Hispanic Blacks (NHB) and Whites (NHW) adjusting for relevant covariates. RESULTS: NHBs were 67% of the sample, -61% earned < $20,000, and 78% earned < $35,000. Unadjusted mean HbA1c (8.0 vs 7.6, P = .024), SBP (134 vs 126 P < .001), DBP (76 vs 69, P < .001) and LDL (96 vs 87, P = .003) levels were significantly higher in NHBs. Adjusted linear regression showed that SBP (beta = 9.4; 4.5-8.6) and DBP (beta = 5.7; 3.5-7.9) were significantly higher in NHBs. 12.6% had composite control and NHBs had lower composite control (10.0% vs 17.6%). Adjusted logistic models showed that BP control (OR .45; .30-.67) and composite control (OR .57; .33-.98) were significantly lower in NHBs. CONCLUSIONS: In this diverse sample of primary care patients with T2DM, NHBs had significantly lower BP control and composite outcome control compared to NHWs adjusting for relevant confounding factors. Strategies are needed to optimize control of multiple outcomes and reduce disparities in patients with T2DM.




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