Health Behaviors and Quality of Care Among Latinos With Diabetes in Managed Care

Brown, Arleen F.; Gerzoff, Robert B.; Karter, Andrew J.; Gregg, Edward W.; Safford, Monika M.; Waitzfelder, Beth E.; Beckles, Gloria L.; Brusuelas, Rebecca J; Mangione, Carol M.

doi:10.2105/ajph.93.10.1694

Cited by 70 publications

(61 citation statements)

References 20 publications

(13 reference statements)

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“…Two other studies, after adjusting extensively, reported different outcomes in glycemic control. One study (60) demonstrated no ethnic differences in glycemic control, while another study (50) showed worse control among Hispanics. Overall, intermediate outcomes of care were worse in blacks, and outcomes among Hispanics were inclined to be worse.…”

Section: Ethnic Differences In Intermediate Outcomes Of Carementioning

confidence: 99%

“…One study (54) reported equal quality of care (process of care) for blacks, and three studies (15, 32,55) noted predominantly a higher quality of care for blacks. For Hispanics, two studies (32,54) reported equal quality of process of care, two studies (14,64) reported lower quality, and one study (50) higher quality. One study (61) involved non-English-speaking Asians (56% of the Asians compared with 7% of whites were non-English speaking).…”

Section: Ethnic Differences In Quality Of Carementioning

confidence: 99%

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Ethnic Differences in Mortality, End-Stage Complications, and Quality of Care Among Diabetic Patients

et al. 2005

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OBJECTIVE -To determine the influence of ethnic differences in diabetes care on inequalities in mortality and prevalence of end-stage complications among diabetic patients. The following questions were examined: 1) Are there ethnic differences among diabetic patients in mortality and end-stage complications and 2) are there ethnic differences among diabetic patients in quality of care?RESEARCH DESIGN AND METHODS -A review of the literature on ethnic differences in the prevalence of complications and mortality among diabetic patients and in the quality of diabetes care was performed by systematically searching articles on Medline published from 1987 through October 2004.RESULTS -A total of 51 studies were included, mainly conducted in the U.S. and the U.K. In general, after adjusting for confounders, diabetic patients from ethnic minorities had higher mortality rates and higher risk of diabetes complications. After additional adjustment for risk factors such as smoking, socioeconomic status, income, years of education, and BMI, in most instances ethnic differences disappear. Nevertheless, blacks and Hispanics in the U.S. and Asians in the U.K. have an increased risk of end-stage renal disease, and blacks and Hispanics in the U.S. have an increased risk of retinopathy. Intermediate outcomes of care were worse in blacks, and they were inclined to be worse in Hispanics. Likewise, ethnic differences in quality of care in the U.S. exist: process of care was worse in blacks.CONCLUSIONS -Given the fact that there are ethnic differences in diabetes care and that ethnic differences in some diabetes complications persist after adjustment for risk factors other than diabetes care, it seems the case that ethnic differences in diabetes care contribute to the more adverse disease outcomes of diabetic patients from some ethnic minority groups. Although no generalizations can be made for all ethnic groups in all regions for all kinds of complications, the results do implicate the importance of quality of care in striving for equal health outcomes among ethnic minorities. Diabetes Care 28:2280 -2288, 2005D iabetes is one of the most common chronic diseases in Europe and the U.S. (1-3). Diabetes is divided into etiologic subclasses, of which type 1 and type 2 are the most prevalent (4). The prevalence of type 1 and, in particular, type 2 diabetes is rising in all European countries (2). Type 2 diabetes is the major contributor to the epidemic rise in diabetes because this type accounts for Ͼ90% of diabetes. In the U.S., the overall prevalence of diabetes increased from 4.9% in 1990 to 6.5% in 1998 (5). There is a parallel rise in the prevalence of complications related to diabetes.The prevalence of diabetes varies, among other factors, by ethnicity. Several studies (3,6,7) on ethnic differences in diabetes have reported higher prevalence and incidence rates among ethnic minorities. Furthermore, end-stage complications of diabetes have been reported to be more common among ethnic minorities (8 -10), who also experience higher morta...

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Section: Ethnic Differences In Intermediate Outcomes Of Carementioning

confidence: 99%

Section: Ethnic Differences In Quality Of Carementioning

confidence: 99%

Ethnic Differences in Mortality, End-Stage Complications, and Quality of Care Among Diabetic Patients

et al. 2005

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“…Adherence may be improved by using a once-daily versus twice-daily basal insulin; however, as the insulin regimen continues to be adjusted, the total number of injections per day may counter this benefit, as The significant difference in HbA 1c values between Hispanics and whites observed in our study has been reported elsewhere. [30][31][32][33] The results of the regression model exploring patients' characteristics on refill frequency are revealing. Patients who are female, black, Hispanic, or of Native American heritage obtain fewer refills than do those who are white or Asian.…”

Section: Discussionmentioning

confidence: 99%

Effect of switching medically vulnerable patients with uncontrolled diabetes from isophane insulin human to insulin glargine

Erickson

Devine

O’Young

et al. 2006

American Journal of Health-System Pharmacy

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Purpose. The purpose of this observational study was to determine if switching from isophane insulin human (NPH) to insulin glargine would improve glycemic control in a medically vulnerable population with uncontrolled diabetes. Methods. A retrospective cohort review of patients' medical records was performed that recorded events occurring between January 1, 2001, and December 31, 2003. The cohort consisted of patients with diabetes in an adult medicine clinic at a county hospital. Patients were included if they were receiving NPH insulin for a minimum of six months and subsequently switched to insulin glargine for a minimum of six months. Results. The study included 43 patients. There was no significant difference in mean glycosylated hemoglobin (HbA 1c ) between NPH insulin (9.6%) and insulin glargine (9.7%) regimens (p = 0.78, 95% confidence interval, -0.62%, 0.82%). Neither was there a significant difference in the frequency or severity of hypoglycemic episodes between the two treatments. Patients experienced significantly fewer diabetesassociated visits over six months while on insulin glargine. Refill frequency did not differ significantly when patients were receiving NPH insulin versus insulin glargine. When analyzing patient characteristics, those of Hispanic ethnicity experienced HbA 1c values significantly higher than white patients. Several characteristics were associated with refill frequency. Conclusion. The results of our study indicate that both NPH-and glargine-based basal insulin regimens result in similar levels of glycemic control in a medically vulnerable population with diabetes, without significant differences in the number or severity of hypoglycemic episodes or in refill frequency.

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“…There also is a relationship between Hispanic adults with type 2 Diabetes and poorer glycemic control [5]. Hispanic individuals experience more complications related to their diabetes and difficulty with self-management compared to their Caucasian adult counterparts [5][6].…”

mentioning

confidence: 99%

“…Hispanic individuals experience more complications related to their diabetes and difficulty with self-management compared to their Caucasian adult counterparts [5][6]. Disparities in the experiences of Hispanics and Caucasians result in variances in the respective groups' access to health-care services, as well as their utilization of these services.…”

mentioning

confidence: 99%

Diabetes Diagnosis is related to Anxiety Among Mexican Americans But Not non-Hispanic Adults: A Project FRONTER study

Mauer¹,

Johnson²,

Schrimsher³

2012

J Depress Anxiety

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This study examined the link between diabetes and specific anxiety symptoms among Mexican Americans in comparison with non-Hispanics in a rural sample. The prevalence of Hispanic, and more specifically, Mexican American individuals with diabetes, is larger than their white, non-Hispanic counterparts. Adults with diabetes also experience psychological dysfunction, particularly an elevation in anxiety symptoms. Both non-Hispanic and Hispanic individuals have been found to experience co-occurring anxiety disorders and diabetes. Hispanic individuals have a higher prevalence of both anxiety and diabetes than non-Hispanic individuals. Cross-sectional data were analyzed from 582 rural dwelling individuals from an ongoing rural health study, Project FRONTIER. The Beck Anxiety Inventory (BAI) and the factor scores previously derived by the test's authors (i.e., Subjective, Neurophysiological, Autonomic, and Panic) were entered as predictor variables into regression models with Diabetes diagnosis as the outcome variable. Among Mexican Americans, diabetes diagnosis was significantly related to BAI total score. The diagnoses were significantly related to all of the BAI factor scores. Specifically, Panic, Autonomic, Neurophysiological, and Subjective factor scores. Diabetes diagnosis was not related to BAI total or factor scores among non-Hispanics. Research and clinical implications are discussed.

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Health Behaviors and Quality of Care Among Latinos With Diabetes in Managed Care

Cited by 70 publications

References 20 publications

Ethnic Differences in Mortality, End-Stage Complications, and Quality of Care Among Diabetic Patients

Ethnic Differences in Mortality, End-Stage Complications, and Quality of Care Among Diabetic Patients

Effect of switching medically vulnerable patients with uncontrolled diabetes from isophane insulin human to insulin glargine

Diabetes Diagnosis is related to Anxiety Among Mexican Americans But Not non-Hispanic Adults: A Project FRONTER study

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