Ambulatory medical care for non-Hispanic whites, African-Americans, and Mexican-Americans with NIDDM in the U.S.
OBJECTIVE
To assess whether medical care for diabetes is different among non-Hispanic whites, African-Americans, and Mexican-Americans with NIDDM.


METHODS
A questionnaire was administered to a representative U.S. sample of 2,170 noninstitutionalized adults with NIDDM. Information was obtained on physician visits, hyperglycemic therapy, monitoring of glycemic control, screening for and monitoring of complications, and diabetes education.


RESULTS
About 90% of subjects had a regular diabetes physician, and the physician visit rate was similar by race (median of four visits per year). African-Americans were more likely to be treated with insulin (51.9%) than non-Hispanic whites (35.9%, P < 0.0001) and Mexican-Americans (46.2%). Among insulin-treated subjects, African-Americans were less likely to use multiple daily insulin injections (35.1 vs. 53.8% of non-Hispanic whites [P < 0.0001] and 50.5% of Mexican-Americans [P = 0.027]) and were less likely to self-monitor their blood glucose at least once per day (14.0 vs. 29.8% of non-Hispanic whites [P < 0.0001] and 29.0% of Mexican-Americans). The rates of visits to specialists for diabetes complications, physician testing of blood glucose, and screening for hypertension, retinopathy, and foot problems were not substantially different among the three race/ethnic groups. A higher proportion of African-Americans (43.3%) than non-Hispanic whites (31.5%, P < 0.0001) and Mexican-Americans (25.6%, P = 0.001) had received patient education; however, the median number of hours of instruction was lower for African-Americans.


CONCLUSIONS
The frequency of diabetes care is similar among non-Hispanic whites, African-Americans, and Mexican-Americans. The major differences relate to methods of glycemic control and patient education.
Cowie
C C
CC
National Institute of Diabetes and Digestive and Kidney Diseases, National Institute of Health, Bethesda, MD 20892-6600, USA.
Harris
M I
MI
D000293:Adolescent; D000328:Adult; D001741:Black or African American; D000553:Ambulatory Care / Q000706:statistics & numerical data*; D001786:Blood Glucose / Q000032:analysis; D015190:Blood Glucose Self-Monitoring / Q000706:statistics & numerical data; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000208:ethnology / Q000628:therapy*; D017719:Diabetic Foot / Q000453:epidemiology / Q000208:ethnology / Q000517:prevention & control; D003927:Diet, Diabetic; D017050:Episode of Care; D005260:Female; D006801:Humans; D008297:Male; D017058:Mexican Americans; D008875:Middle Aged; D010353:Patient Education as Topic / Q000706:statistics & numerical data; D017678:Sex Distribution; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology; D044465:White People
D001786:Blood Glucose