Race and Sex Differences in Diabetic Complications in a Large Health Care System

Abstract

Existing studies of racial differences in diabetic complications between African Americans and whites have provided conflicting results. The objective of this study was to investigate race and sex differences in diabetic complications between African-American and white patients in Louisiana’s largest integrated health delivery system. We performed a prospective cohort study of 28,218 African Americans and 31,237 whites with diabetes. Cox proportional hazards regression was used to estimate the relative risk of each of four health outcomes between African Americans and whites. The age- and sex-adjusted incident rates per 1,000 person-years and 95% confidence intervals (CI) of coronary heart disease (CHD), heart failure, stroke, and end-stage renal disease (ESRD) for African-American patients with diabetes were 59.8 (95% CI 57.7-62.0), 43.5 (41.7-45.4), 34.0 (32.4-35.7), and 56.5 (53.8-59.3), respectively. Compared with African-American patients with diabetes, white patients with diabetes had a higher age- and sex-adjusted incident rate of CHD [63.3 (61.2-65.3)] and lower rates of heart failure [32.0 (30.6-33.4)], stroke [29.7 (28.4-31.1)] and ESRD [45.7 (44.0-47.4)]. Men with diabetes had higher age-adjusted incident rates of CHD, heart failure, and ESRD than women with diabetes. Results of the Cox proportional hazard models confirmed racial and sex differences observed in the age- and sex-adjusted incident rates. African Americans with diabetes have higher risks of heart failure, stroke and ESRD than white counterparts, whereas whites with diabetes have a higher risk of CHD than African-American counterparts. Disclosure P. Yin: None. L. Shi: None. E. Nauman: None. P.T. Katzmarzyk: None. E.G. Price-Haywood: None. A.N. Bazzano: None. Y. Shen: None. G. Hu: None.