Racial and Ethnic Differences in Health Care Access and Health Outcomes for Adults With Type 2 Diabetes
Article Figures & Tables
Tables
- Table 1 —
Characteristics of type 2 diabetic adults, according to race and ethnicity
Non-Hispanic Caucasian Non-Hispanic African-American Mexican-American Median age (years) 63.4 59.5* 56.1† Median duration since diabetes diagnosis (years) 6.4 7.6 5.4 Men 46.0 37.3‡ 38.7‡ High school education or more 61.1 42.7† 23.1† Family income ≥$20,000 58.6 31.5† 35.0† Mean BMI (kg/m2) Men 29.8 28.3* 29.3 Women 30.8 32.6‡ 31.0 Hypertension 65.9 71.4 53.8‡ Dyslipidemia 65.3 62.2 51.2* - Table 2 —
Health care access for type 2 diabetic adults
Health care access Non-Hispanic Caucasian Non-Hispanic African-American Mexican-American One usual source of ambulatory medical care 96.7 93.9 91.9 Sees one primary physician at this source 92.4 88.2 83.1 Two or more physician visits in past 12 months 90.3 86.6 83.2 Health insurance Age 25–64 years 91.4 88.7 65.9* Age ≥65 years 99.8 100.0 99.7 Private health insurance Age 25–64 years 80.8 62.9* 46.2* Age ≥65 years 80.3 42.9* 40.9* Diabetes therapy Insulin 25.7 41.6† 25.3 Oral agents 45.7 36.5‡ 50.3 Diet alone 28.6 21.9 24.4 Insulin treated, ≥2 injections per day 60.4 42.3† 48.2 Self-monitors blood glucose at least once per day Not insulin-treated 5.8 3.9 2.4 Insulin-treated 44.2 26.7† 27.3† Eye examination in the past year 65.3 70.1 60.8 Blood pressure checked in the past 6 months 88.4 89.4 83.4 Cholesterol checked 80.8 68.1* 61.8* Hypertension Previously diagnosed, taking antihypertensive medication 83.1 84.1 71.3‡ Previously diagnosed, not taking antihypertension medication 6.4 6.8 12.8‡ Undiagnosed 10.5 9.1 15.9 Dyslipidemia Previously diagnosed, treated with diet or medication 52.3 40.3‡ 40.6‡ Previously diagnosed, not treated with diet or medication 6.2 4.5 4.3 Undiagnosed 41.6 55.3‡ 55.1‡ -
Data are %. Sample sizes for hypertension (n = 864) and dyslipidemia (n = 627) exclude subjects who do not have these conditions; dyslipidemia data also exclude subjects with triglyceride levels ≥400 mg/dl for whom the Friedewald equation to compute LDL cholesterol is not valid.
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↵* P < 0.001
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↵† P < 0.01
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↵‡ P < 0.05 compared with non-Hispanic Caucasians.
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- Table 3 —
Health status and outcomes for type 2 diabetic adults
Health care outcome Non-Hispanic Caucasian Non-Hispanic African-American Mexican-American HbA1c ≥7.0% 55.1 58.2 65.5* BMI ≥30 kg/m2 Men 43.5 34.3 37.0 Women 45.5 53.7 48.2 Microalbuminuria 29.6 27.3 26.3 Clinical proteinuria 5.2 13.6† 11.2* Previously diagnosed hypertension Blood pressure <140/90 mmHg 45.2 39.6 34.7 Blood pressure ≥140/90 mmHg 54.8 60.4 65.3 Previously diagnosed dyslipidemia LDL cholesterol <130 mg/dl 35.4 23.9 37.9 LDL cholesterol ≥130 mg/dl 64.6 76.1 62.1 Serum total cholesterol (mg/dl) <200 31.1 35.7 38.1 200–239 34.5 33.9 33.8 ≥240 34.4 30.4 28.1 HDL cholesterol (mg/dl) <35 28.9 13.0† 20.1‡ 35–45 32.7 28.0 33.9 >45 38.4 59.0† 46.0‡ Triglyceride (mg/dl) <200 57.1 74.8† 57.3 200–399 30.8 19.7* 27.9 ≥400 12.1 5.5‡ 14.8 LDL cholesterol (mg/dl) <100 15.4 19.6 21.1‡ 100–129 32.8 24.9‡ 36.4 130–159 30.6 28.6 26.6 ≥160 21.2 26.9 15.9 Lipoprotein(a) >30 mg/dl 20.1 58.8† 21.3 Homocysteine >15 μmol/l 13.9 11.5 6.5‡ Cigarette smoker 18.0 23.9 17.7 Hospitalized in past 12 months 27.1 27.9 22.6 -
Data are %. The upper limit of normal for HbA1c in the assay system is 6.1%, defined as the mean + 2 SD (5.27 + 0.85%) for the group of people with fasting plasma glucose <110 mg/dl and 2-h postchallenge glucose <140 mg/dl. Samples sizes for previously diagnosed hypertension (n = 618) and previously diagnosed dyslipidemia (n = 302) exclude subjects who have not been diagnosed with these conditions; dyslipidemia data also exclude subjects with triglyceride levels ≥400 mg/dl for whom the Friedewald equation to compute LDL cholesterol is not valid.
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↵* P < 0.01
- †
↵† P < 0.001
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↵‡ P < 0.05 compared with non-Hispanic Caucasians.
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