Identifying risk factors for racial disparities in diabetes outcomes: the translating research into action for

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O Kenrik Duru1, Robert B Gerzoff, Joseph V Selby

  • 1Division of General Internal Medicine/Health Services Research, David Geffen School of Medicine, University of California, Los Angeles, CA 90095, USA. kduru@mednet.ucla.edu

Medical Care
|June 2, 2009
PubMed

Insights

Black patients with diabetes experience worse outcomes due to higher rates of depression and missed medication doses. Addressing these factors may reduce racial disparities in diabetes care.

Area of Science:

  • Medical research
  • Health disparities
  • Diabetes management

Background:

  • Black individuals with diabetes exhibit poorer glycemic control (hemoglobin A1c), elevated blood pressure (SBP), and higher LDL cholesterol compared to white individuals.
  • These disparities are linked to increased morbidity and microvascular complications in Black patients.

Purpose of the Study:

  • To investigate if mutable risk factors are more strongly associated with poor control of multiple diabetes outcomes in Black patients compared to White patients.
  • To identify specific modifiable factors contributing to racial disparities in diabetes management.

Main Methods:

  • A case-control study involving 764 Black and White patients with diabetes receiving care within managed health plans.
  • Cases had poor control of at least two of three outcomes (HbA1c, SBP, LDL cholesterol); controls had good control of all three.
  • Multivariate analyses assessed the association of depression, medication adherence, self-efficacy, and patient-provider communication with case/control status.

Main Results:

  • Depression and missed medication doses were significantly associated with poor diabetes control (being a case) in Black patients (OR 2.28 and 1.96, respectively).
  • These associations were not observed in White patients.
  • Other assessed risk factors did not show significant associations for either racial group.

Conclusions:

  • Depression and medication non-adherence are more strongly linked to poor diabetes control in Black individuals compared to White individuals.
  • These findings highlight depression and medication adherence as critical targets for interventions aimed at reducing racial disparities in diabetes outcomes.
Abstract

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