Racial and Ethnic Disparities in Diabetes Care Among Veterans
Author Information
Author(s): Wendel Christopher S, Shah Jayendra H, Duckworth William C, Hoffman Richard M, Mohler M Jane, Murata Glen H
Primary Institution: Southern Arizona VA Health Care System
Hypothesis
Does race/ethnicity affect the control of cardiovascular disease risk factors in veterans with type 2 diabetes?
Conclusion
Insulin-treated minority veterans, particularly African Americans, had poorer glycemic control and received lower doses of insulin than non-Hispanic whites, but there were no differences in the control of other cardiovascular disease risk factors.
Supporting Evidence
- African Americans had the highest A1c levels and were most likely to have poor glycemic control.
- Non-Hispanic whites received significantly higher daily insulin doses compared to Hispanics and African Americans.
- No significant racial/ethnic differences were found in lipid or blood pressure control.
Takeaway
This study found that some groups of veterans with diabetes, especially African Americans, are not getting the insulin they need to manage their blood sugar well.
Methodology
A cross-sectional observational study was conducted using electronic pharmacy databases to select veterans with insulin-treated type 2 diabetes, collecting data on various health factors.
Potential Biases
Potential under-reporting of insulin doses by minority patients and cultural barriers affecting treatment intensity.
Limitations
The study may not be generalizable to younger patients, non-veterans, or women, and there may be selection bias affecting the results.
Participant Demographics
The cohort included 67% non-Hispanic whites, 21% Hispanics, and 10% African Americans, with a mean age of 65.1 years and 96% men.
Statistical Information
P-Value
p = 0.002 for African Americans compared to non-Hispanic whites
Statistical Significance
p<0.05
Digital Object Identifier (DOI)
Want to read the original?
Access the complete publication on the publisher's website