Related Experiment Videos
Characterization of factors affecting attainment of glycemic control in Asian Americans with diabetes in a culturally
Hung Le1, Sophia Wong1, Tracy Iftikar1
1Asian American Diabetes Initiative, Joslin Diabetes Center, Harvard Medical School, Boston, Massachusetts (Mr Le, Mrs Wong, Mrs Iftikar, Dr King, Dr Hsu)
Purpose:
The purpose of this study is to examine the effectiveness of a culturally specific pilot clinic for Asian Americans (AA) in reaching glycemic target and to characterize factors affecting the attainment of glycemic control in comparison with white counterparts.
Methods:
This electronic health record review included all new AA patients with type 2 diabetes (n = 109) in a culturally specific program and a randomly selected sample of new white patients with type 2 diabetes (n = 218) in the adult clinic within the same time period and diabetes center.
Results:
AA and whites had a comparable proportion of patients with A1C ≤7% (32.1%, 34.9%; P = .621) at baseline and after 12 months of care (48.6%, 56.0%; P = .210), with a similar A1C decline (-0.9% ± 1.6%, -0.8% ± 1.7%, P = .710) by 12 months. Factors associated with the lack of success in reaching target in AA but not in whites included older age, lower educational attainment, less likelihood of having health insurance, and a need for more educational visits. The percentage of AA reaching A1C ≤7%, as compared to whites, worsened among those with highest initial A1C when stratified by ascending quartiles (96.7% vs 85.2%, P = .101; 61.9% vs 58.9%, P = .813; 24.0% vs 37.7%, P = .230; 15.2% vs 35.4%, P = .044).
Conclusion:
While a culturally specific diabetes program in a specialty setting achieved a similar glycemic outcome for AA compared with whites, reasons for not reaching glycemic target differed. The findings suggest that the elimination of diabetes disparities requires not only culturally and linguistically specific programs, but must also identify and address the socio-environmental differences unique to each population.
Related Concept Videos
Diabetes: Management and Pharmacotherapy
Insulin remains the cornerstone of treatment for most patients with type 1 and many...
Diabetes Mellitus: Type 2 and Gestational
Stress Prevention and Stress Management Techniques VI
Motivation and Self-Determination
Motivation, the driving force behind behavior, plays a pivotal role at every stage of the change process. The research...
Type II Diabetes Mellitus III: Clinical Manifestations and Diagnosis
Type I Diabetes III: Clinical Manifestations
Type II Diabetes I: Introduction