Racial/ethnic differences in control of cardiovascular risk factors among type 2 diabetes patients in an insured, ambulatory care population

Abstract

Aims This paper examines differences in cardiovascular disease risk factor control among racial/ethnic minorities (Asian Indian, Chinese, Filipino, Japanese, Korean, Vietnamese, Hispanic/Latino, Black/African Americans) with type 2 diabetes compared to Non-Hispanic Whites with type 2 diabetes in an insured, outpatient setting. Methods A three-year, cross-sectional sample of 15,826 patients with type 2 diabetes was studied between 2008 and 2010. Goal attainment rates for three cardiovascular disease risk factors (HbA1c, BP, LDL) were estimated. Logistic regression was used to determine the association between patient characteristics and control of risk factors. Results Only one fifth (21.1%) of patients achieved simultaneous goal attainment (HbA1c, BP, LDL). After adjustment for patient characteristics and treatment, Black/African American women and men, and Filipino and Hispanic/Latino men were significantly less likely to simultaneously achieve all three goals, compared to Non-Hispanic Whites. Of the three goals, patients were more likely to achieve HbA1c goals (68.7%) than BP (45.7%) or LDL (58.5%) goals. Racial/ethnic differences were more apparent in risk factors that were under better control (i.e. HbA1c). Conclusions Cardiovascular risk factor control in type 2 diabetes is suboptimal, even in an insured population. Special attention may be required for specific racial/ethnic/gender groups.

Impulsivity as a moderator of the associations between child maltreatment types and body mass index

“…In line with the existing evidence (Holland et al, 2013; Huang et al, 2007), results from the current study showed that male and racial/ethnic minority participants had higher BMIs than female and Caucasian participants, respectively. With regard to maltreatment, results showed that, compared to Caucasian participants, racial/ethnic minority participants reported greater exposure to all five maltreatment types.…”

Cardiovascular Risk Factor Targets and Cardiovascular Disease Event Risk in Diabetes: A Pooling Project of the Atherosclerosis Risk in Communities Study, Multi-Ethnic Study of Atherosclerosis, and Jackson Heart Study

“…Control of risk factors (BP, LDL-C, HbA 1c , and smoking cessation) in DM patients with CHD is also suboptimal, with simultaneous control rates varying from 8% to 23% (24). Risk factor control also varies substantially by ethnicity (25), suggesting a need for health care systems to develop approaches to ensure better composite control of risk factors. Meta-analyses of randomized trials (26,27) evaluating quality improvement interventions in adults with type 2 DM have shown modest improvements in HbA 1c , BP, and LDL-C with increased use of aspirin and antihypertensive drugs, but not with statin use.…”

Cardiovascular Disease Risk Factors in Youth With Diabetes Mellitus

“…The incidence of T2DM is the highest among youth who are American Indian (25.3 and 49.4 per 100 000 per year for those 10-14 and 15-19 years of age, respectively), followed by NHB (22.3 and 19.4 per 100 000 per year), Asian/Pacific Islander (11.8 and 22.7 per 100 000 per year), and Hispanic (8.9 and 17.0 per 100 000 per year), and lowest (3.0 and 5.6 per 100 000 per year) among NHW. 40 Second, minority youth have higher rates of obesity, hypertension, dyslipidemia, and other metabolic syndrome components associated with T2DM 41 and have higher HbA 1c , more CVD risk factors, and higher rates of diabetic ketoacidosis. 42 In particular, NHB adolescents are more likely to have hypertension, arterial stiffness, and higher C-reactive protein, 42,43 all possible explanations for the higher rates of myocardial infarction and stroke seen in NHB adults.…”