Glycemic control in a sample of black and white clinic patients with NIDDM

To compare glycemic control of black and white patients under treatment for non-insulin-dependent diabetes mellitus (NIDDM).

Medical records of patients with NIDDM were reviewed at 19 of 24 clinics or health centers in a specified area of north central Florida. Data were abstracted from the charts of all non-Hispanic black (n = 248) or white (n = 280) patients who met preset eligibility criteria.

The mean +/- SD age was 58 +/- 14 years; the mean +/- SD duration of diabetes was 9 +/- 7.5 years. Of 528 patients, 220 were treated with oral hypoglycemic agents, 269 were treated with insulin, 28 were treated with diet alone, and 11 were treated with a combination of oral agents, diet, and insulin. Glycosylated hemoglobin was > or = 8% for 47% of black women, 41% of black men, 38% of white men, and 29% of white women. The less favorable control status of the black women persisted within categories of age (40-59 years or > or = 60 years), treatment (insulin or oral hypoglycemic agents), time since diagnosis (less than versus greater than or equal to the median of 7 years), and obesity (noted versus not noted in chart). In multiple logistic regression analyses controlling simultaneously for these variables, the odds (95% confidence interval [CI]), compared with white women, of having glycosylated hemoglobin > or = 8% were 2.2 (1.4, 3.4) for black women and 1.5 (0.8, 2.9) and 1.4 (0.8, 2.5) for black and white men, respectively.

Black women were more likely than white women or men to have glycosylated hemoglobin > or = 8%. This difference was not readily explained by age, type of treatment, time since diagnosis, or a notation of obesity in the medical record, although an effect of obesity cannot be excluded on this basis.