Use of diabetes preventive care and complications risk in two African-American communities.
BACKGROUND
We examined levels of diabetes preventive care services and glycemic and lipid control among African Americans with diabetes in two North Carolina communities.


METHODS
Cross-sectional, population-based study of 625 African-American adults with diagnosed diabetes. Participants had a household interview to determine receipt of preventive care services including glycosylated hemoglobin (HbA(1c)), blood pressure, lipid, foot, dilated eye, and dental examinations; diabetes education; and health promotion counseling. A total of 383 gave blood samples to determine HbA(1c) and lipid values.


RESULTS
Annual dilated eye, foot, and lipid examinations were reported by 70% to 80% of the population, but only 46% reported HbA(1c) tests. Rates of regular physical activity (31%) and daily self-monitoring of blood glucose (40%) were low. Sixty percent of the population had an HbA(1c) level >8% and one fourth had an HbA(1c) level >10%. Half of the population had a low-density lipoprotein value >130 mg/dL. Lack of insurance was the most consistent correlate of inadequate care (odds ratio [OR]=2.3; 95% confidence interval [CI]=1.3-3.9), having HbA(1c) >9.5% (OR=2.1, 95% CI=1.1-4.2), and LDL levels >130 mg/dL (OR=2.1; 95% CI=1.0-4.5).


CONCLUSIONS
Levels of diabetes preventive care services were comparable to U.S. estimates, but glycemic and lipid control and levels of self-management behaviors were poor. These findings indicate a need to understand barriers to achieving and implementing good glycemic and lipid control among African Americans with diabetes.
Gregg
E W
EW
Division of Diabetes Translation, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia 30341, USA. edg7@cdc.gov
Geiss
L S
LS
Saaddine
J
J
Fagot-Campagna
A
A
Beckles
G
G
Parker
C
C
Visscher
W
W
Hartwell
T
T
Liburd
L
L
Narayan
K M
KM
Engelgau
M M
MM
D000293:Adolescent; D000328:Adult; D001741:Black or African American; D000368:Aged; D000369:Aged, 80 and over; D008078:Cholesterol, LDL / Q000097:blood; D003430:Cross-Sectional Studies; D048909:Diabetes Complications; D003920:Diabetes Mellitus / Q000208:ethnology*; D005260:Female; D006441:Hemoglobin A / Q000032:analysis; D006801:Humans; D006943:Hyperglycemia / Q000097:blood / Q000517:prevention & control; D008297:Male; D008875:Middle Aged; D009657:North Carolina; D010349:Patient Compliance / Q000208:ethnology; D011314:Preventive Health Services / Q000706:statistics & numerical data*; D012648:Self Care
D008078:Cholesterol, LDL; D006441:Hemoglobin A