Abdominal obesity and ethnic differences in diabetes awareness, treatment, and glycemic control.
OBJECTIVE
To compare racial/ethnic differences in diabetes awareness, treatment, and glycemic control between non-Hispanic white, non-Hispanic black, and Hispanic Americans. We also determined the impact of abdominal obesity on racial/ethnic differences in diabetes awareness, treatment, and glycemic control between these population groups.


METHODS
Third National Health and Nutrition Examination Survey (NHANES III) data were utilized for this study. Diabetes awareness was defined as acknowledging diabetic status. Diabetes treatment was defined as current use of anti-diabetic medications, good glycemic control as HbA(1c) < 8%, and abdominal obesity as waist circumference larger than expected. The impacts of abdominal obesity on racial/ethnic differences in diabetes awareness, treatment, and glycemic control were assessed using logistic regression analyses. Adjustments were made for age, education, smoking, alcohol intake, and health insurance.


RESULTS
Rates of diabetes awareness in whites, blacks, and Hispanics suffering from abdominal obesity were approximately 74%, 30%, and 21% in men and 77%, 32%, and 19% in women, respectively. Rates of diabetes treatment were 70%, 23%, and 14% in men and 57%, 45%, and 23% in women, respectively. In men, rates of glycemic control were 64%, 40%, and 30%, and in women, they were 62%, 51%, and 27%, respectively. Abdominal obesity was associated with decreased diabetes awareness and glycemic control in women.


CONCLUSIONS
Subjects with abdominal obesity were found to have poorer glycemic controls compared to those without abdominal obesity. Because diabetes prevalences were partially explained by racial/ethnic differences in diabetes awareness, treatment, and glycemic control, there is a need to craft diabetes awareness, treatment, and control programs along racial/ethnic origins.
Okosun
Ike S
IS
Department of Community Medicine, Mercer University School of Medicine, Macon, Georgia 31207, USA. okosun_i@mercer.edu
Dever
G E Alan
GE
D000005:Abdomen; D000328:Adult; D001741:Black or African American; D000368:Aged; D000428:Alcohol Drinking / Q000453:epidemiology; D001364:Awareness; D001786:Blood Glucose / Q000032:analysis*; D001824:Body Constitution; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy* / Q000453:epidemiology; D004522:Educational Status; D005006:Ethnicity; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006630:Hispanic or Latino; D006801:Humans; D007348:Insurance, Health; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009749:Nutrition Surveys; D009765:Obesity / Q000150:complications / Q000453:epidemiology; D012727:Sex Characteristics; D012907:Smoking / Q000453:epidemiology; D044465:White People
D001786:Blood Glucose; D006442:Glycated Hemoglobin