HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text (PDF) All Versions of this Article: dc07-0382v1 31/2/240    most recent Purchase Article View Shopping Cart Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Kirk, J. K. Articles by Quandt, S. A. Search for Related Content PubMed PubMed Citation Articles by Kirk, J. K. Articles by Quandt, S. A. Social Bookmarking                What's this?

Disparities in A1C Levels between Hispanics and Non-Hispanic White Adults with Diabetes: A Meta-Analysis

Julienne K. Kirk, PharmD, CDE^*, Leah V. Passmore, MS, Ronny A. Bell, PhD, K.M. Venkat Narayan, MD, MPH, MBA, Ralph B. D'Agostino, Jr, PhD, Thomas A. Arcury, PhD^* and Sara A. Quandt, PhD

*Department of Family and Community Medicine
Division of Public Health Sciences, Department of Biostatical Sciences
Division of Public Health Sciences, Department of Epidemiology and Prevention, Wake Forest University School of Medicine, Winston-Salem, North Carolina
Emory University, Atlanta, Georgia and Guest Researcher, Division of Diabetes Translation, Centers for Disease Control, Atlanta Georgia

jkirk{at}wfubmc.edu

ABSTRACT

Objective: Hispanics have higher rates of diabetes and diabetes-related complications than do non-Hispanic whites. A meta-analysis was conducted to estimate the difference between the mean values of hemoglobin A1c (A1C)for these two groups.

Research Design And Methods: We executed a PubMed search of articles published from 1993 through July 2007. Data sources included PubMed, Web of Science, Cumulative Index to Nursing and Allied Health, the Cochrane Library, Combined Health Information Database, and Education Resources Information Center. Data on sample size, age, gender, A1C, geographical location, and study design were extracted. Cross-sectional data and baseline data from clinical trials and cohort studies for Hispanics and non-Hispanic whites with diabetes were included. Studies were excluded if they included persons <18 years of age or patients with prediabetes or gestational diabetes.

Results: A total of 495 studies were reviewed, of which 73 contained data on A1C for Hispanics and non-Hispanic whites, and 11 met inclusion criteria. Meta-analysis revealed a statistically significant mean difference (p<0.0001) of -0.46 (95% confidence interval, -0.63, -0.33), correlating to an approximately 0.5% higher A1C for Hispanics. Grouping studies by design (cross-sectional or cohort), method of data collection for A1C (chart review or blood draw), and care type (managed or non-managed) yielded similar results.

Conclusion: In this meta-analysis, A1C was approximately one-half percent higher in Hispanic patients with diabetes than in non-Hispanic patients. Understanding reasons for this disparity should be a focus for future research.

CiteULike    Del.icio.us    Digg    Reddit    Technorati    What's this?

This article has been cited by other articles:

				B. R. Shah Utilization of physician services for diabetic patients from ethnic minorities J. Public Health Med., September 1, 2008; 30(3): 327 - 331. [Abstract] [Full Text] [PDF]