March 2008 - Results of an analysis of multiple studies show diabetes control is more challenging for Hispanics than non-Hispanic whites, according to researchers at Wake Forest University Baptist Medical Center and colleagues.
The results revealed that Hispanic patients with diabetes have approximately 0.5 percent higher levels on a test that measures blood sugar control, called the A1C test, than non-Hispanic white patients. The researchers noted the consistency of these findings across the studies.
An A1C test measures hemoglobin linked with glucose, or blood sugar, over a time period of two to three months. Higher A1C values indicate patients have difficulty controlling their blood sugar.
The results of the "meta-analysis" are reported in the February issue of Diabetes Care.
A meta-analysis combines the results of several studies that used similar methods and procedures. This allows the capability to generate larger numbers than from a single study and detect differences that didn't show up in individual studies.
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"These findings are interesting because they evaluate all available information from studies that include both Hispanic and non-Hispanic whites over a period of 13 years," said Julienne Kirk, PharmD, associate professor of family and community medicine at Wake Forest University School of Medicine, and lead author of the study.
Kirk says that knowing some minority groups may have higher A1C could impact early treatment and awareness.
The researchers reviewed 495 studies, and narrowed their analysis down to 11 studies that comprised results of A1C tests for Hispanics and non-Hispanic whites, who were at least 18 years of age, and were not considered to have prediabetes or gestational diabetes.
According to the Centers for Disease Control and Prevention (CDC), the incidence per 1,000 of diagnosed diabetes of those between 18 and 79 years was 10.2 percent for Hispanic or Latino individuals compared with 6.9 percent for non-Hispanic whites in 2005.
"We were not surprised by these findings since ethnic minorities in the U.S. are disproportionately affected by diabetes, and we found a similar trend in the African American population with diabetes a year ago," said Kirk. "What did surprise us were the results of our analysis of subgroups of patients with managed care and non-managed care insurance. The largest difference for A1C was among non-managed care insurance groups."
The authors recommend development of strategies that focus not only on discovering the source of the differences in diabetes control between the two groups, but also on reducing these disparities.
"A high percentage of Hispanics in this country have low incomes, no health insurance, and limited access to health care," said Kirk. "The Hispanic population has a high prevalence of diabetes and higher A1C than non-Hispanic whites. This further elucidates the health disparities that characterize the Hispanic population."
Co-authors for the study were Leah Passmore, M.S., Ronny Bell, Ph.D., Ralph D'Agostino Jr., Ph.D., Thomas Arcury, Ph.D., Sara Quandt, Ph.D., all with Wake Forest, and K.M. Venkat Narayan, M.D., M.P.H., M.B.A., with Emory University. The research was funded by the CDC and the Association of Teachers of Preventative Medicine.
Source: Wake Forest University Baptist Medical Center
