Diabetes care in black and white veterans in the southeastern U.S.

Diabetes Care
Jennifer G TwomblyLawrence S Phillips

Abstract

Eliminating health disparities is a national priority, but progress has been difficult because of racial/ethnic differences in insurance coverage and access to health care. We investigated whether there were differences in diabetes care in the Veterans Administration (VA), where health care access should be relatively uniform. A1C and plasma glucose were compared before/after diagnosis of diabetes. Data were available for 1,456 black and 2,624 white veterans who met criteria for consistent primary care. Over 4-5 years before and after diagnosis, blacks had similar glucose and approximately 0.2% higher A1C levels than whites, and A1C differences could be attributed to glucose-independent associations between race and A1C. Blacks and whites also had comparable intervals between diagnostic-level hyperglycemia and diagnosis and between diagnosis and drug initiation. However, A1C was higher in blacks at the time of diagnosis (7.8 vs. 7.1%) and at initiation of pharmacotherapy (8.5 vs. 7.8%) (both P < 0.001). Differences in A1C at diagnosis and drug initiation were too large to be explained by differences in age, sex, BMI, and glucose-independent associations between race and A1C. In the VA, glucose levels are generally comparable in...Continue Reading

References

May 22, 2002·JAMA : the Journal of the American Medical Association·Andrew J KarterJoe V Selby
Aug 4, 2004·The Journal of Ambulatory Care Management·William H RogersR Graeme Fincke
Nov 29, 2005·Journal of Health Care for the Poor and Underserved·Mary K RheeLawrence S Phillips
Mar 17, 2006·The New England Journal of Medicine·Steven M AschElizabeth A McGlynn
Dec 6, 2007·Journal of General Internal Medicine·Pramod MeduruUsha Sambamoorthi
Mar 13, 2008·Journal of General Internal Medicine·David C ZiemerLawrence S Phillips
Aug 2, 2008·The Diabetes Educator·Mary K RheeLawrence S Phillips
Feb 25, 2009·Archives of Internal Medicine·Chi-yuan HsuAlan S Go
Mar 12, 2009·The Journal of Clinical Endocrinology and Metabolism·William H HermanSherry Martin
Jun 9, 2009·Diabetes Care·UNKNOWN International Expert Committee

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Citations

Sep 7, 2011·Prostate Cancer and Prostatic Diseases·K A MosesM M Issa
Apr 14, 2011·Hepatology : Official Journal of the American Association for the Study of Liver Diseases·Michael T MeliaUNKNOWN IDEAL Study Team
Mar 12, 2015·Journal of Diabetes Science and Technology·Lawrence S PhillipsQi Long
Mar 12, 2013·The Diabetes Educator·Katura C BullockAmie Taggart Blaszczyk
Oct 16, 2016·Drug Safety : an International Journal of Medical Toxicology and Drug Experience·Dominic WayFrederic Bouder

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Methods Mentioned

BETA
amputations
pharmacotherapy

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