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Identifying Risk Factors for Racial Disparities in Diabetes Outcomes
| Content Provider | Scilit |
|---|---|
| Author | Duru, O. Kenrik Gerzoff, Robert B. Selby, Joseph V. Brown, Arleen Ackermann, Ronald T. Karter, Andrew J. Ross, Sonja Steers, W. Neil Herman, William H. Waitzfelder, Beth Mangione, Carol M. |
| Copyright Year | 2009 |
| Description | Journal: Medical Care Background: Versus whites, blacks with diabetes have poorer control of hemoglobin A1c (HbA1c), higher systolic blood pressure (SBP), and higher low-density lipoprotein (LDL) cholesterol as well as higher rates of morbidity and microvascular complications. Objective: To examine whether several mutable risk factors were more strongly associated with poor control of multiple intermediate outcomes among blacks with diabetes than among similar whites. Design: Case-control study. Subjects: A total of 764 blacks and whites with diabetes receiving care within 8 managed care health plans. Measures: Cases were patients with poor control of at least 2 of 3 intermediate outcomes (HbA1c ≥8.0%, SBP ≥140 mmHg, LDL cholesterol ≥130 mg/dL) and controls were patients with good control of all 3 (HbA1c <8.0%, SBP <140 mmHg, LDL cholesterol <130 mg/dL). In multivariate analyses, we determined whether each of several potentially mutable risk factors, including depression, poor adherence to medications, low self-efficacy for reducing cardiovascular risk, and poor patient-provider communication, predicted case or control status. Results: Among blacks but not whites, in multivariate analyses depression (odds ratio: 2.28; 95% confidence interval: 1.09–4.75) and having missed medication doses (odds ratio: 1.96; 95% confidence interval: 1.01–3.81) were associated with greater odds of being a case rather than a control. None of the other risk factors were associated for either blacks or whites. Conclusions: Depression and missing medication doses are more strongly associated with poor diabetes control among blacks than in whites. These 2 risk factors may represent important targets for patient-level interventions to address racial disparities in diabetes outcomes. |
| Related Links | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2743318/pdf |
| Ending Page | 706 |
| Page Count | 7 |
| Starting Page | 700 |
| ISSN | 00257079 |
| e-ISSN | 15371948 |
| DOI | 10.1097/mlr.0b013e318192609d |
| Journal | Medical Care |
| Issue Number | 6 |
| Volume Number | 47 |
| Language | English |
| Publisher | Ovid Technologies (Wolters Kluwer Health) |
| Publisher Date | 2009-06-01 |
| Access Restriction | Open |
| Subject Keyword | Journal: Medical Care Endocrinology and Metabolism Diabetes, Racial/ethnic Groups, Health Outcomes |
| Content Type | Text |
| Resource Type | Article |
| Subject | Public Health, Environmental and Occupational Health |
