Demographic Differences in the Treatment and Control of Glucose in Type 2 Diabetic Patients: Implications for Health Care Practice
Identifying modifiable covariables that reduce demographic disparities in controlling type 2 diabetes could inform efforts to improve health equity. This retrospective study utilized electronic health record data on 22,285 adults with type 2 diabetes seen at 110 outpatient clinics in the Southeast U...
Gespeichert in:
| Veröffentlicht in: | Ethnicity & disease 2012, Vol.22 (1), p.29-37 |
|---|---|
| Hauptverfasser: | , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 37 |
|---|---|
| container_issue | 1 |
| container_start_page | 29 |
| container_title | Ethnicity & disease |
| container_volume | 22 |
| creator | Egan, Brent M. Shaftman, Stephanie R. Wagner, C. Shaun Bandyopadhyay, Dipankar Szymanski, Keith A. |
| description | Identifying modifiable covariables that reduce demographic disparities in controlling type 2 diabetes could inform efforts to improve health equity.
This retrospective study utilized electronic health record data on 22,285 adults with type 2 diabetes seen at 110 outpatient clinics in the Southeast U.S. from 2004-2008. Demographic differences in diabetes control and modifiable covariables which reduce those disparities were quantified using descriptive and logistic regression analysis.
Patients were 55.8 +/- 14.6 (SD) years old, 57.5% women, 61.0% white: 39.0% black and had baseline body mass index 34. +/- .3 kg/ m2 and HbA1c 7.61 +/- 1.9%. The percentage with HbAlc |
| format | Article |
| fullrecord | <record><control><sourceid>jstor_proqu</sourceid><recordid>TN_cdi_proquest_miscellaneous_1024476269</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><jstor_id>48667621</jstor_id><sourcerecordid>48667621</sourcerecordid><originalsourceid>FETCH-LOGICAL-j233t-fd21086846bf45241880640b008f7613fc369eb25867954407d45b44c605f7b33</originalsourceid><addsrcrecordid>eNo9kD1PwzAURT2AaCn8BJBHlkj-jjOiFlqkSjAUCYkhcpJnmiqJg-0M_fcYtTC94Z57dPUu0JwSUWSSko8Zug7hQAiTUogrNGMszwUnao4-V9C7L2_GfVvjVWsteBhqCLgdcNwD3nkwsYchYjM0eOmG6F2HncXrbqpdgF9udxwBs9Q2FcSkeTOxTY1wgy6t6QLcnu8CvT8_7ZabbPu6flk-brMD4zxmtmGUaKWFqqyQTFCtiRKkIkTbXFFua64KqJjUKi_SfpI3QlZC1IpIm1ecL9DDyTt69z1BiGXfhhq6zgzgplBSwoTIFVNFQu_P6FT10JSjb3vjj-XfQxJwdwIOITr_nwutVDJQ_gNYUGLp</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1024476269</pqid></control><display><type>article</type><title>Demographic Differences in the Treatment and Control of Glucose in Type 2 Diabetic Patients: Implications for Health Care Practice</title><source>Jstor Complete Legacy</source><source>MEDLINE</source><source>EZB-FREE-00999 freely available EZB journals</source><creator>Egan, Brent M. ; Shaftman, Stephanie R. ; Wagner, C. Shaun ; Bandyopadhyay, Dipankar ; Szymanski, Keith A.</creator><creatorcontrib>Egan, Brent M. ; Shaftman, Stephanie R. ; Wagner, C. Shaun ; Bandyopadhyay, Dipankar ; Szymanski, Keith A.</creatorcontrib><description>Identifying modifiable covariables that reduce demographic disparities in controlling type 2 diabetes could inform efforts to improve health equity.
This retrospective study utilized electronic health record data on 22,285 adults with type 2 diabetes seen at 110 outpatient clinics in the Southeast U.S. from 2004-2008. Demographic differences in diabetes control and modifiable covariables which reduce those disparities were quantified using descriptive and logistic regression analysis.
Patients were 55.8 +/- 14.6 (SD) years old, 57.5% women, 61.0% white: 39.0% black and had baseline body mass index 34. +/- .3 kg/ m2 and HbA1c 7.61 +/- 1.9%. The percentage with HbAlc <7% was higher in Whites than blacks (55.6% vs. 44.7%, P < .0001) and rose with age in all patients from 45.3% at <50, to 50.0% at 50-64, and 59.6% at > or =65 years, P < .001. white vs. black race (odds ratio [OR] 1.59, 95% confidence interval [CI] 1.51-1.68) and age/ 10 years (OR 1.20/10 years, 95% CI 1.17-1.22) were predictors of HbAlc <7% in univariable logistic regression. In multivariable analysis, three modifiable covariables (initial HbAlc, therapeutic inertia, visit frequency) accounted for 47.9% of variance in diabetes control. When accounting for these modifiable covariables, the independent impact of race/ethnicity (OR 1.21, 95% CI 1.13-1.30) and age (OR 1.13, 95% Cl 1.11-1.16) on HbA1c control declined.
Race and age-related difference in diabetes control declined significantly when modifiable covariates were considered. Greater attention to early diagnosis and treatment, ensuring regular healthcare visits and overcoming therapeutic inertia could improve diabetes control and health equity.</description><identifier>ISSN: 1049-510X</identifier><identifier>PMID: 22774306</identifier><language>eng</language><publisher>United States: Ethnicity & Disease, Inc</publisher><subject>Adult ; Age Factors ; Aged ; Black or African American ; Black People - statistics & numerical data ; Blood Glucose - analysis ; Body Mass Index ; Chi-Square Distribution ; Comorbidity ; Demography ; Diabetes Mellitus, Type 2 - blood ; Diabetes Mellitus, Type 2 - epidemiology ; Diabetes Mellitus, Type 2 - ethnology ; Female ; Humans ; Logistic Models ; Male ; Middle Aged ; Original Reports: Diabetes ; Retrospective Studies ; Risk Factors ; Southeastern United States - epidemiology ; White People - statistics & numerical data</subject><ispartof>Ethnicity & disease, 2012, Vol.22 (1), p.29-37</ispartof><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.jstor.org/stable/pdf/48667621$$EPDF$$P50$$Gjstor$$H</linktopdf><linktohtml>$$Uhttps://www.jstor.org/stable/48667621$$EHTML$$P50$$Gjstor$$H</linktohtml><link.rule.ids>314,776,780,799,57992,58225</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/22774306$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Egan, Brent M.</creatorcontrib><creatorcontrib>Shaftman, Stephanie R.</creatorcontrib><creatorcontrib>Wagner, C. Shaun</creatorcontrib><creatorcontrib>Bandyopadhyay, Dipankar</creatorcontrib><creatorcontrib>Szymanski, Keith A.</creatorcontrib><title>Demographic Differences in the Treatment and Control of Glucose in Type 2 Diabetic Patients: Implications for Health Care Practice</title><title>Ethnicity & disease</title><addtitle>Ethn Dis</addtitle><description>Identifying modifiable covariables that reduce demographic disparities in controlling type 2 diabetes could inform efforts to improve health equity.
This retrospective study utilized electronic health record data on 22,285 adults with type 2 diabetes seen at 110 outpatient clinics in the Southeast U.S. from 2004-2008. Demographic differences in diabetes control and modifiable covariables which reduce those disparities were quantified using descriptive and logistic regression analysis.
Patients were 55.8 +/- 14.6 (SD) years old, 57.5% women, 61.0% white: 39.0% black and had baseline body mass index 34. +/- .3 kg/ m2 and HbA1c 7.61 +/- 1.9%. The percentage with HbAlc <7% was higher in Whites than blacks (55.6% vs. 44.7%, P < .0001) and rose with age in all patients from 45.3% at <50, to 50.0% at 50-64, and 59.6% at > or =65 years, P < .001. white vs. black race (odds ratio [OR] 1.59, 95% confidence interval [CI] 1.51-1.68) and age/ 10 years (OR 1.20/10 years, 95% CI 1.17-1.22) were predictors of HbAlc <7% in univariable logistic regression. In multivariable analysis, three modifiable covariables (initial HbAlc, therapeutic inertia, visit frequency) accounted for 47.9% of variance in diabetes control. When accounting for these modifiable covariables, the independent impact of race/ethnicity (OR 1.21, 95% CI 1.13-1.30) and age (OR 1.13, 95% Cl 1.11-1.16) on HbA1c control declined.
Race and age-related difference in diabetes control declined significantly when modifiable covariates were considered. Greater attention to early diagnosis and treatment, ensuring regular healthcare visits and overcoming therapeutic inertia could improve diabetes control and health equity.</description><subject>Adult</subject><subject>Age Factors</subject><subject>Aged</subject><subject>Black or African American</subject><subject>Black People - statistics & numerical data</subject><subject>Blood Glucose - analysis</subject><subject>Body Mass Index</subject><subject>Chi-Square Distribution</subject><subject>Comorbidity</subject><subject>Demography</subject><subject>Diabetes Mellitus, Type 2 - blood</subject><subject>Diabetes Mellitus, Type 2 - epidemiology</subject><subject>Diabetes Mellitus, Type 2 - ethnology</subject><subject>Female</subject><subject>Humans</subject><subject>Logistic Models</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Original Reports: Diabetes</subject><subject>Retrospective Studies</subject><subject>Risk Factors</subject><subject>Southeastern United States - epidemiology</subject><subject>White People - statistics & numerical data</subject><issn>1049-510X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2012</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNo9kD1PwzAURT2AaCn8BJBHlkj-jjOiFlqkSjAUCYkhcpJnmiqJg-0M_fcYtTC94Z57dPUu0JwSUWSSko8Zug7hQAiTUogrNGMszwUnao4-V9C7L2_GfVvjVWsteBhqCLgdcNwD3nkwsYchYjM0eOmG6F2HncXrbqpdgF9udxwBs9Q2FcSkeTOxTY1wgy6t6QLcnu8CvT8_7ZabbPu6flk-brMD4zxmtmGUaKWFqqyQTFCtiRKkIkTbXFFua64KqJjUKi_SfpI3QlZC1IpIm1ecL9DDyTt69z1BiGXfhhq6zgzgplBSwoTIFVNFQu_P6FT10JSjb3vjj-XfQxJwdwIOITr_nwutVDJQ_gNYUGLp</recordid><startdate>2012</startdate><enddate>2012</enddate><creator>Egan, Brent M.</creator><creator>Shaftman, Stephanie R.</creator><creator>Wagner, C. Shaun</creator><creator>Bandyopadhyay, Dipankar</creator><creator>Szymanski, Keith A.</creator><general>Ethnicity & Disease, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>7X8</scope></search><sort><creationdate>2012</creationdate><title>Demographic Differences in the Treatment and Control of Glucose in Type 2 Diabetic Patients</title><author>Egan, Brent M. ; Shaftman, Stephanie R. ; Wagner, C. Shaun ; Bandyopadhyay, Dipankar ; Szymanski, Keith A.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-j233t-fd21086846bf45241880640b008f7613fc369eb25867954407d45b44c605f7b33</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2012</creationdate><topic>Adult</topic><topic>Age Factors</topic><topic>Aged</topic><topic>Black or African American</topic><topic>Black People - statistics & numerical data</topic><topic>Blood Glucose - analysis</topic><topic>Body Mass Index</topic><topic>Chi-Square Distribution</topic><topic>Comorbidity</topic><topic>Demography</topic><topic>Diabetes Mellitus, Type 2 - blood</topic><topic>Diabetes Mellitus, Type 2 - epidemiology</topic><topic>Diabetes Mellitus, Type 2 - ethnology</topic><topic>Female</topic><topic>Humans</topic><topic>Logistic Models</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Original Reports: Diabetes</topic><topic>Retrospective Studies</topic><topic>Risk Factors</topic><topic>Southeastern United States - epidemiology</topic><topic>White People - statistics & numerical data</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Egan, Brent M.</creatorcontrib><creatorcontrib>Shaftman, Stephanie R.</creatorcontrib><creatorcontrib>Wagner, C. Shaun</creatorcontrib><creatorcontrib>Bandyopadhyay, Dipankar</creatorcontrib><creatorcontrib>Szymanski, Keith A.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>MEDLINE - Academic</collection><jtitle>Ethnicity & disease</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Egan, Brent M.</au><au>Shaftman, Stephanie R.</au><au>Wagner, C. Shaun</au><au>Bandyopadhyay, Dipankar</au><au>Szymanski, Keith A.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Demographic Differences in the Treatment and Control of Glucose in Type 2 Diabetic Patients: Implications for Health Care Practice</atitle><jtitle>Ethnicity & disease</jtitle><addtitle>Ethn Dis</addtitle><date>2012</date><risdate>2012</risdate><volume>22</volume><issue>1</issue><spage>29</spage><epage>37</epage><pages>29-37</pages><issn>1049-510X</issn><abstract>Identifying modifiable covariables that reduce demographic disparities in controlling type 2 diabetes could inform efforts to improve health equity.
This retrospective study utilized electronic health record data on 22,285 adults with type 2 diabetes seen at 110 outpatient clinics in the Southeast U.S. from 2004-2008. Demographic differences in diabetes control and modifiable covariables which reduce those disparities were quantified using descriptive and logistic regression analysis.
Patients were 55.8 +/- 14.6 (SD) years old, 57.5% women, 61.0% white: 39.0% black and had baseline body mass index 34. +/- .3 kg/ m2 and HbA1c 7.61 +/- 1.9%. The percentage with HbAlc <7% was higher in Whites than blacks (55.6% vs. 44.7%, P < .0001) and rose with age in all patients from 45.3% at <50, to 50.0% at 50-64, and 59.6% at > or =65 years, P < .001. white vs. black race (odds ratio [OR] 1.59, 95% confidence interval [CI] 1.51-1.68) and age/ 10 years (OR 1.20/10 years, 95% CI 1.17-1.22) were predictors of HbAlc <7% in univariable logistic regression. In multivariable analysis, three modifiable covariables (initial HbAlc, therapeutic inertia, visit frequency) accounted for 47.9% of variance in diabetes control. When accounting for these modifiable covariables, the independent impact of race/ethnicity (OR 1.21, 95% CI 1.13-1.30) and age (OR 1.13, 95% Cl 1.11-1.16) on HbA1c control declined.
Race and age-related difference in diabetes control declined significantly when modifiable covariates were considered. Greater attention to early diagnosis and treatment, ensuring regular healthcare visits and overcoming therapeutic inertia could improve diabetes control and health equity.</abstract><cop>United States</cop><pub>Ethnicity & Disease, Inc</pub><pmid>22774306</pmid><tpages>9</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1049-510X |
| ispartof | Ethnicity & disease, 2012, Vol.22 (1), p.29-37 |
| issn | 1049-510X |
| language | eng |
| recordid | cdi_proquest_miscellaneous_1024476269 |
| source | Jstor Complete Legacy; MEDLINE; EZB-FREE-00999 freely available EZB journals |
| subjects | Adult Age Factors Aged Black or African American Black People - statistics & numerical data Blood Glucose - analysis Body Mass Index Chi-Square Distribution Comorbidity Demography Diabetes Mellitus, Type 2 - blood Diabetes Mellitus, Type 2 - epidemiology Diabetes Mellitus, Type 2 - ethnology Female Humans Logistic Models Male Middle Aged Original Reports: Diabetes Retrospective Studies Risk Factors Southeastern United States - epidemiology White People - statistics & numerical data |
| title | Demographic Differences in the Treatment and Control of Glucose in Type 2 Diabetic Patients: Implications for Health Care Practice |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-02-05T20%3A16%3A53IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-jstor_proqu&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Demographic%20Differences%20in%20the%20Treatment%20and%20Control%20of%20Glucose%20in%20Type%202%20Diabetic%20Patients:%20Implications%20for%20Health%20Care%20Practice&rft.jtitle=Ethnicity%20&%20disease&rft.au=Egan,%20Brent%20M.&rft.date=2012&rft.volume=22&rft.issue=1&rft.spage=29&rft.epage=37&rft.pages=29-37&rft.issn=1049-510X&rft_id=info:doi/&rft_dat=%3Cjstor_proqu%3E48667621%3C/jstor_proqu%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=1024476269&rft_id=info:pmid/22774306&rft_jstor_id=48667621&rfr_iscdi=true |