Diabetes
Care 1997 Feb;20(2):142-7
Ambulatory medical care for non-Hispanic whites, African-Americans,
and Mexican-Americans with NIDDM in the U.S.
Cowie CC, Harris MI.
National Institute of Diabetes and Digestive and Kidney Diseases, National
Institute of Health, Bethesda, MD 20892-6600, USA.
OBJECTIVE: To assess whether medical care for diabetes
is different among non-Hispanic whites, African-Americans, and Mexican-Americans
with NIDDM.
RESEARCH DESIGN AND METHODS: A questionnaire was administered
to a representative U.S. sample of 2,170 noninstitutionalized adults with
NIDDM. Information was obtained on physician visits, hyperglycemic therapy,
monitoring of glycemic control, screening for and monitoring of complications,
and diabetes education.
RESULTS: About 90% of subjects had a regular diabetes
physician, and the physician visit rate was similar by race (median of
four visits per year). African-Americans were more likely to be treated
with insulin (51.9%) than non-Hispanic whites (35.9%, P < 0.0001) and
Mexican-Americans (46.2%). Among insulin-treated subjects, African-Americans
were less likely to use multiple daily insulin injections (35.1 vs. 53.8%
of non-Hispanic whites [P < 0.0001] and 50.5% of Mexican-Americans
[P = 0.027]) and were less likely to self-monitor their blood glucose
at least once per day (14.0 vs. 29.8% of non-Hispanic whites [P < 0.0001]
and 29.0% of Mexican-Americans). The rates of visits to specialists for
diabetes complications, physician testing of blood glucose, and screening
for hypertension, retinopathy, and foot problems were not substantially
different among the three race/ethnic groups. A higher proportion of African-Americans
(43.3%) than non-Hispanic whites (31.5%, P < 0.0001) and Mexican-Americans
(25.6%, P = 0.001) had received patient education; however, the median
number of hours of instruction was lower for African-Americans.
CONCLUSIONS: The frequency of diabetes care is similar
among non-Hispanic whites, African-Americans, and Mexican-Americans. The
major differences relate to methods of glycemic control and patient education.
PMID: 9118761 [PubMed - indexed for MEDLINE]