A Comparison of Standards of Diabetes Care Across Different Racial/Ethnic Groups in the United States Non-institutionalized Adult Population: A Study Using the 2009-2010 NHANES Cohort

Objective. To compare the quality of diabetes care across non-Hispanic whites and Blacks and Hispanics in the United States using selected American Diabetes Association standards of care. Background. There are few studies using large federal databases evaluating disparities among racial/ethnic groups in diabetes care. The last one was conducted using the Medication Expenditure Panel Survey 2000-2001 cohort. Methods. Data from the National Health and Nutritional Examination Survey 2009-2010 cohort was used to compare quality markers such as diabetes-related access to care (physician and diabetes specialists visits), medical care (self-monitoring, treatment, dietary habits, laboratories) and co-morbidities (prevalence, treatment and monitoring) across the racial/ethnic groups. We used one-way ANOVA and chi-square test to compare continuous and discrete variables across Whites, Blacks, Hispanics and other. Results. Overall this group had a mean age of 61±14, 51% were male, 60% had no more than a high school diploma, and 55% had an income \u3c $35,000. Only age and education level were different across groups (p \u3c 0.05). Average blood pressure and total cholesterol levels were at goal except for hemoglobin A1c which was 7.3%±1.7 and different across groups (p = 0.003). We found that the use of insulin, frequency of blood glucose monitoring, foot and exam in the last year, nurse educator/nutritionist/dietitian visits, and diabetic retinopathy, hypertension and hyperlipidemia diagnoses were significantly different across groups (all p \u3c 0.05). Conclusion. A possible relationship 30 between race/ethnicity and adherence to various standards of diabetes care may exist. A more rigorous epidemiologic study is needed to confirm our findings. Grants. Not funded