Diabetes and age-related demographic differences in risk factor control
Brent M Egan1, Jiexiang Li2, Tamara E Wolfman3
1Care Coordination Institute, Greenville Health System, Greenville, SC, USA; Department of Medicine, University of South Carolina School of Medicine, Greenville Health System, Greenville, SC, USA; Department of Medicine, Medical University of South Carolina, Charleston, SC, USA.
Journal of the American Society of Hypertension : JASH
|June 23, 2014
Summary
Racial disparities exist in diabetes management, with white patients achieving better control of blood sugar, cholesterol, and blood pressure than black and Hispanic patients, particularly before age 65. Improved insurance and treatment effectiveness are crucial for equitable care.
Area of Science:
- Public Health
- Cardiovascular Disease Research
- Health Disparities
Background:
- Vascular complications in diabetes show disparities across racial and ethnic groups.
- Differential risk factor control, especially before Medicare eligibility, may explain these outcomes.
Purpose of the Study:
- To assess concurrent control of key diabetes risk factors (glycohemoglobin, non-HDL-cholesterol, blood pressure) by race/ethnicity and age.
- To identify factors influencing risk factor control in diabetic populations.
Main Methods:
- Analysis of National Health and Nutrition Examination Surveys (1999-2010) data for adults with diagnosed or undiagnosed diabetes.
- Comparison of concurrent target attainment across white, black, and Hispanic individuals aged <65 and ≥65 years.
- Evaluation of healthcare insurance, utilization, and treatment predictors.
Main Results:
- Concurrent target attainment was significantly higher in white individuals (<65 years) compared to black and Hispanic individuals.
- Healthcare insurance disparities were more pronounced in younger minority populations.
- Cholesterol treatment strongly predicted concurrent risk factor control across both age groups.
Conclusions:
- Overall concurrent risk factor control in diabetes is low across all racial/ethnic groups.
- Target attainment disparities are evident, particularly in younger adults, linked to insurance and treatment access.
- Strategies to improve insurance coverage, risk factor awareness, and treatment effectiveness are needed for equitable diabetes care.
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