Heisler noted that these disparities are consistent with Medicare eligibility. "It appears that Medicare is working, it is making a difference," she said.
When the researchers looked at factors that contribute to good blood sugar control, the usual indicators -- such as education, income and access to health care -- didn't play a significant role, Heisler said.
One finding was particularly significant, Heisler said. "African-Americans reported that they didn't take their medications as prescribed," she said. "Medication adherence was one of the most important predictors of blood sugar control."
Heisler looks at this as an encouraging finding, because it's something that can be changed. "We have to do a better job with African-Americans to explain medications and why they are important," she said.
Diabetes-related distress was also an important contributor to poor blood sugar control, particularly among Latinos, Heisler said. "Latinos reported much higher levels of distress related to diabetes than whites," she said. "In general, we need to focus more on helping patients self-manage their diabetes."
Yet these factors, while significant, only explain about one-fifth of the disparity between whites and blacks and Latinos, Heisler said. Other factors could include the quality of health care, medication doses and environmental factors and overall stress, she said.
The findings were published in the Sept. 24 issue of the Archives of Internal Medicine.
Dr. Larry Deeb, president for medicine and science at the American Diabetes Association, thinks doctors need to be more aggressive in treating diabetes among blacks and Latinos.
Based on A1C levels, blacks and Latinos are at significantly greater risk than whites for the complications of diabetes, Deeb said. Those complications include blindness, heart attack, kidney failure an
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