Even so, all the factors examined in the analyses that might account for the observed racial and ethnic disparities in glycemic control accounted for only 14 percent of the African American-white disparity, and 19 percent of the Latino-white disparity, in blood sugar control. Meanwhile, differences in income and education level two factors long hypothesized to be key determinants of worse diabetes outcomes did not explain the glucose control differences, once the other factors were included in the analyses.
The authors conclude that additional factors not assessed in the study, such as genetics, stress levels and other environmental factors, intensity of medication regimens, and the generosity of patients prescription drug insurance coverage must account for a large part of the picture.
Medication adherence was one of the strongest predictors of glucose control across the board, says Heisler. This reinforces that by targeting barriers to medication adherence such as patient-doctor communication about medications, patient trust in health systems, patient confidence that medication actually helps, cost barriers, and other barriers that African Americans disproportionately face we can make a difference.
"Diabetes is one of the most important health challenges faced by Americans and American society today," notes Richard Suzman, Ph.D., director of behavioral and social research at the National Institute on Aging. "These results illuminate some of the behavioral and other issues associated wit
|Contact: Kara Gavin|
University of Michigan Health System