Disparities in A1C Levels Between Hispanic and Non-Hispanic White Adults With Diabetes
Author:
Kirk Julienne K.1, Passmore Leah V.2, Bell Ronny A.3, Narayan K.M. Venkat4, D'Agostino Ralph B.2, Arcury Thomas A.1, Quandt Sara A.3
Affiliation:
1. Department of Family and Community Medicine, Wake Forest University School of Medicine, Winston-Salem, North Carolina 2. Division of Public Health Sciences, Department of Biostatical Sciences, Wake Forest University School of Medicine, Winston-Salem, North Carolina 3. Division of Public Health Sciences, Department of Epidemiology and Prevention, Wake Forest University School of Medicine, Winston-Salem, North Carolina 4. Hubert Department of Global Health, Emory University and Division of Diabetes Translation, Centers for Disease Control and Prevention, Atlanta Georgia
Abstract
OBJECTIVE—Hispanics have higher rates of diabetes and diabetes-related complications than do non-Hispanic whites. A meta-analysis was conducted to estimate the difference between the mean values of A1C for these two groups.
RESEARCH DESIGN AND METHODS—We executed a PubMed search of articles published from 1993 through July 2007. Data sources included PubMed, Web of Science, Cumulative Index to Nursing and Allied Health, the Cochrane Library, Combined Health Information Database, and Education Resources Information Center. Data on sample size, age, sex, A1C, geographical location, and study design were extracted. Cross-sectional data and baseline data from clinical trials and cohort studies for Hispanics and non-Hispanic whites with diabetes were included. Studies were excluded if they included individuals <18 years of age or patients with pre-diabetes or gestational diabetes.
RESULTS—A total of 495 studies were reviewed, of which 73 contained data on A1C for Hispanics and non-Hispanic whites, and 11 met the inclusion criteria. Meta-analysis revealed a statistically significant mean difference (P < 0.0001) of −0.46 (95% CI −0.63 to −0.33), correlating to an ∼0.5% higher A1C for Hispanics. Grouping studies by design (cross-sectional or cohort), method of data collection for A1C (chart review or blood sampling), and care type (managed or nonmanaged) yielded similar results.
CONCLUSIONS—In this meta-analysis, A1C was ∼0.5% higher in Hispanic patients with diabetes than in non-Hispanic patients. Understanding the reasons for this disparity should be a focus for future research.
Publisher
American Diabetes Association
Subject
Advanced and Specialized Nursing,Endocrinology, Diabetes and Metabolism,Internal Medicine
Reference39 articles.
1. Centers for Disease Control: Early release of selected estimates based on data from January–March 2006 National Health Interview Survey. Available from http://www.cdc.gov/nchs/data/nhis/earlyrelease/200609_14.pdf. Accessed 14 February 2007 2. Stern PM, Mitchell BD: Diabetes in Hispanics Americans. In Diabetes in America. 2nd ed. National Diabetes Data Group, Eds. Bethesda, MD, National Institutes of Health, 1995, p. 631–659 3. Narayan KM, Boyle JP, Thompson TJ, Sorensen SW, Williamson DF: Lifetime risk for diabetes mellitus in the United States. JAMA 290: 1884–1890, 2003 4. Hamman RF, Marshall JA, Baxter J, Kahn LB, Mayer EJ, Orleans M, Murphy JR, Lezotte DC: Methods and prevalence of non-insulin-dependent diabetes mellitus in a biethnic Colorado population: the San Antonio Heart Study. Am J Epidemiol 129: 295–311, 1989 5. Flegal KM, Ezzati TM, Harris MI, Haynes SG, Juarez RZ, Knowler WC, Perez-Stable EJ, Stern MP: Prevalence of diabetes in Mexican Americans, Cubans, and Puerto Ricans from Hispanic Health and Nutrition Survey, 1982–1984. Diabetes Care 14: 628–638, 1991
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