Abstract
AimsThis paper examines differences in cardiovascular disease risk factor control among racial/ethnic minorities (Asian Indian, Chinese, Filipino, Japanese, Korean, Vietnamese, Hispanic/Latino, Black/African Americans) with type 2 diabetes compared to Non-Hispanic Whites with type 2 diabetes in an insured, outpatient setting. MethodsA three-year, cross-sectional sample of 15,826 patients with type 2 diabetes was studied between 2008 and 2010. Goal attainment rates for three cardiovascular disease risk factors (HbA1c, BP, LDL) were estimated. Logistic regression was used to determine the association between patient characteristics and control of risk factors. ResultsOnly one fifth (21.1%) of patients achieved simultaneous goal attainment (HbA1c, BP, LDL). After adjustment for patient characteristics and treatment, Black/African American women and men, and Filipino and Hispanic/Latino men were significantly less likely to simultaneously achieve all three goals, compared to Non-Hispanic Whites. Of the three goals, patients were more likely to achieve HbA1c goals (68.7%) than BP (45.7%) or LDL (58.5%) goals. Racial/ethnic differences were more apparent in risk factors that were under better control (i.e. HbA1c). ConclusionsCardiovascular risk factor control in type 2 diabetes is suboptimal, even in an insured population. Special attention may be required for specific racial/ethnic/gender groups.
Highlights
Over 20 million Americans are diagnosed with type 2 diabetes (Centers for Disease Control and Prevention, National Center for Health Statistics, 2009), and that number is projected to triple over the couple of decades (Boyle, Thompson, Gregg, Barker, & Williamson, 2010)
A total of 15,826 patients with type 2 diabetes (52.6% Non-Hispanic Whites, 32.9% Asian, 11.7% Hispanic/Latino, and 2.8% Black/African Americans) out of 210,870 total active patients over age 35 were included in the analysis (Table 1)
Hispanic/Latino, and Black/African Americans, were younger compared to Non-Hispanic Whites (NHWs)
Summary
Over 20 million Americans are diagnosed with type 2 diabetes (Centers for Disease Control and Prevention, National Center for Health Statistics, 2009), and that number is projected to triple over the couple of decades (Boyle, Thompson, Gregg, Barker, & Williamson, 2010). This increase is due in large part to the growing number of high-risk racial/ethnic minorities in the U.S The Asian and Hispanic/Latino American populations are expected to see the most growth, doubling in size between 2010 and 2050 to approximately 9% and 30% of the U.S population respectively (U.S Census Bureau, 2009). Control of HbA1c has been better, compared to control of BP and LDL (Chatterji et al, 2012; Cheung et al, 2006; Jackson, Edelman, & Weinberger, 2006; McWilliams, Meara, Zaslavsky, & Ayanian, 2009)
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