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Minorities, Poor Have Tougher Time Monitoring Diabetes

Study found those who used insulin fared worse than white counterparts

FRIDAY, March 14 (HealthDay News) -- Minority and low-income Americans with insulin-treated diabetes are less likely to monitor their blood glucose than other diabetics, a new study shows.

The researchers examined data on 16,630 Hispanic, black and white adults aged 19 and older with insulin-treated diabetes to come to this conclusion.

At every income level, fewer Hispanics and blacks reported daily self-monitoring of blood glucose than whites. The study was to be presented Friday at the American Heart Association's Annual Conference on Cardiovascular Disease Epidemiology and Prevention, in Colorado Springs, Colo.

"Minority and financially vulnerable adults with insulin-treated diabetes appear to have lower reported rates of self-monitoring of blood glucose [SMBG] -- a vital disease management component," study author Dr. Deborah A. Levine, an assistant professor in general internal medicine at the Ohio State University College of Medicine, said in a prepared statement.

"Efforts to improve diabetes control, including the collection and use of SMBG data in Hispanic and black populations with diabetes [particularly those on insulin], are warranted given that Hispanics and blacks have a higher frequency of diabetes-related complications compared to whites. We need to better understand income's role in racial and ethnic disparities in SMBG to offer effective programs and policies to improve SMBG by minorities," Levine said.

The study found that among those with annual household incomes of $20,000 and higher, SMBG rates were 85 percent for whites, 78 percent for Hispanics, and 77 percent for blacks. Among those with household incomes of less than $20,000, SMBG rates were 85 percent for whites, 79 percent for blacks, and 65 percent for Hispanics.

The researchers also found that among those with household incomes of less than $20,000, 49 percent of Hispanics received diabetes education, compared with 62 percent of whites and 64 percent of blacks.

"Receipt of diabetes education varied significantly by race-ethnicity only in the less-than-$20,000 income group," Levine said. "At incomes of $20,000 or more, both Hispanics and blacks had 40 percent lower odds of daily SMBG compared to whites. At incomes of less than $20,000, however, the odds of daily SMBG decreased by 70 percent for Hispanics compared to whites, but did not change for blacks."

These racial and ethnic disparities in self-monitoring of blood glucose were not fully explained by demographic characteristics such as health insurance, health status, or diabetes-related measures such as diabetes education, disease duration or end-organ damage, Levine said.

The findings suggest that poverty significantly worsens self-monitoring of blood glucose and receipt of diabetes education among Hispanics. This means that income must be "explicitly considered when assessing SMBG performance and designing SMBG interventions for Hispanics with insulin-treated diabetes," Levine said.

In 2005, 15.1 million U.S. adults (7.3 percent of the adult population) had diagnosed diabetes, according to the American Heart Association. Of those, 13.2 percent were non-Hispanic black females and 10.7 percent were non-Hispanic black males; 11 percent were Mexican-American males and 10.9 percent were Mexican-American females; and 6.7 percent were white males and 5.6 percent were white females.

More information

The U.S. National Institute of Diabetes and Digestive and Kidney Diseases has more about diabetes control.

-- Robert Preidt

SOURCE: American Heart Association, news release, March 14, 2008

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