Ethnic Differences in Diabetes Management in Patients With and Without Comorbid Medical Conditions: A cross-sectional study

Riyadh Alshamsan; Azeem Majeed; Eszter Panna Vamos; Kamlesh Khunti; Vasa Curcin; Salman Rawaf; Christopher Millett

doi:10.2337/dc10-1606

Original Research

Ethnic Differences in Diabetes Management in Patients With and Without Comorbid Medical Conditions

A cross-sectional study

Riyadh Alshamsan, MSC¹,
Azeem Majeed, MD, FRCGP¹,
Eszter Panna Vamos, MD, PHD¹,
Kamlesh Khunti, MD, PHD²,
Vasa Curcin, MSC, PHD³,
Salman Rawaf, MD, PHD¹ and
Christopher Millett, PHD, FFPH¹

¹Department of Primary Care and Public Health, Imperial College London, London, U.K.
²Department of Health Sciences, University of Leicester, Leicester, U.K.
³Department of Computing, Imperial College London, London, U.K.

Corresponding author: Riyadh Alshamsan, ra105{at}imperial.ac.uk.

Diabetes Care 2011 Mar; 34(3): 655-657. https://doi.org/10.2337/dc10-1606

Abstract

OBJECTIVE To examine ethnic disparities in diabetes management among patients with and without comorbid medical conditions after a period of sustained investment in quality improvement in the U.K.

RESEARCH DESIGN AND METHODS This cross-sectional study examined associations between ethnicity, comorbidity, and intermediate outcomes for mean A1C, total cholesterol, and blood pressure levels in 6,690 diabetes patients in South West London.

RESULTS The presence of ≥2 cardiovascular comorbidities was associated with similar blood pressure control among white and South Asian patients when compared with whites without comorbidity but with worse blood pressure control among black patients, with a mean difference in systolic blood pressure of +1.5, +1.4, and +6.2 mmHg, respectively.

CONCLUSIONS Despite major reforms to improve quality, disparities in blood pressure management have persisted in the U.K., particularly among patients with cardiovascular comorbidities. Policy makers should consider the potential impacts of quality initiatives on high-risk groups.

Received August 19, 2010.
Accepted December 19, 2010.

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