title: A community study of language concordance in Russian patients with diabetes.
abstract: OBJECTIVE
  Unique challenges exist in the provision of culturally and linguistically appropriate health care to ethnically diverse populations. The purpose of this study was to improve the metabolic control of Russian patients with diabetes through increased attention to language and cultural concordance between the provider and patient.
  
  
  METHODS
  This is a retrospective cohort study of 55 Russian immigrant type 2 patients with diabetes to assess levels of glycemic, lipid, and blood pressure control before and after the arrival of a bilingual Russian internist trained in both the United States and Russia. Paired t test was used to compare these parameters before and after the bilingual Russian provider joined our practice.
  
  
  RESULTS
  Overall, the mean low density lipoprotein (LDL) level decreased by 20% from 126 mg/dL to 102 mg/dL (P=.0002) respectively before and after the Russian provider began treating these patients. Mean hemoglobin A1c decreased from 8.4% to 8.0% (P=.007), and diastolic blood pressure was reduced from 82.7 mm Hg to 76.3 mm Hg (P=.0002). Systolic blood pressure also improved from 143.2 mm Hg to 140.6 mm Hg (P=.3). At the end of the study period more than 90% of the patients with diabetes were appropriately taking lipid-lowering medications and an angiotensin converting enzyme (ACE) inhibitor.
  
  
  CONCLUSIONS
  Our findings suggest that it is important to facilitate the health care of ethnically diverse minority populations in a manner that attempts to maximize language and cultural concordance. These potential benefits will assume an even greater importance with the expansive growth of ethnic minorities in the United States and their unique healthcare needs.
authors.affiliation: Department of Internal Medicine Denver Health, Denver, Colorado 80204, USA. Pmehler@dhha.org
authors.forename: Philip S
authors.initials: PS
authors.lastname: Mehler
authors.forename: Rita A
authors.initials: RA
authors.lastname: Lundgren
authors.forename: Irina
authors.initials: I
authors.lastname: Pines
authors.forename: Katherine
authors.initials: K
authors.lastname: Doll
mesh_terms: D000328:Adult; D000368:Aged; D001794:Blood Pressure; D008078:Cholesterol, LDL / Q000097:blood; D003120:Colorado; D003144:Communication Barriers; D003469:Culture; D003924:Diabetes Mellitus, Type 2 / Q000208:ethnology / Q000628:therapy*; D004641:Emigration and Immigration; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D008297:Male; D008875:Middle Aged; D019303:Multilingualism; D010817:Physician-Patient Relations; D012189:Retrospective Studies; D012426:Russia / Q000208:ethnology; D016896:Treatment Outcome; D014481:United States
chemical_list: D008078:Cholesterol, LDL; D006442:Glycated Hemoglobin