title: Evolving demographics and disparities in an urban diabetes clinic: implications for diabetes education and treatment.
abstract: OBJECTIVE
  To compare demographics and disease characteristics in a multiethnic diabetes clinic population to identify changes over time.
  
  
  METHODS
  Analysis and comparison of demographics and disease characteristics of diabetes patients, recorded electronically at intake over 10 years.
  
  
  METHODS
  An urban outpatient diabetes clinic.
  
  
  METHODS
  A total of 8,551 African-American (88%), White (7%), or Hispanic (3%) patients (average age, 52 years; mean diabetes duration, 5.1 years; 59% women).
  
  
  METHODS
  Proportion of patients by ethnic group, age, diabetes duration, initial hemoglobin A1c, and body mass index.
  
  
  RESULTS
  Between 1992 and 2001, the percentage of African-American patients was relatively unchanged (from 87.6% to 87.2%; P=.2), White patients decreased (from 9% to 5%; P=.0006), and Hispanic patients increased (from 1.3% to 5.5%; P<.0001). Among African-American patients, average age decreased from 52 to 50 years (P=.015), diabetes duration decreased from 5.6 years to 4.3 years (P=.0003), initial hemoglobin A1c decreased from 9.3% to 8.8% (P<.0001), and body mass index increased from 31 kg/m2 to 32.1 kg/m2 (P=.0001). Compared with African-American and White patients, Hispanic patients were younger (P<.0001) and had a lower body mass index (P<.0001) but had hemoglobin A1c comparable to that of African-American patients (9.3% vs 9.1%; P=.45) and higher than that of White patients (9.3% vs 8.7%; P=.0022).
  
  
  CONCLUSIONS
  The demographic and disease profiles of patients in this urban diabetes clinic have shifted, and disparities in glycemic control and obesity exist. Modifications in treatment and education approaches may be necessary to compensate for a changing patient population.
authors.affiliation: Grady Health System, Atlanta, Georgia, USA.
authors.forename: Virginia G
authors.initials: VG
authors.lastname: Dunbar
authors.forename: Esther C
authors.initials: EC
authors.lastname: King
authors.forename: Christopher D
authors.initials: CD
authors.lastname: George
authors.forename: Imad M
authors.initials: IM
authors.lastname: El-Kebbi
authors.forename: David C
authors.initials: DC
authors.lastname: Ziemer
authors.forename: Daniel L
authors.initials: DL
authors.lastname: Gallina
authors.forename: Curtiss B
authors.initials: CB
authors.lastname: Cook
mesh_terms: D000293:Adolescent; D000328:Adult; D001741:Black or African American / Q000193:education / Q000706:statistics & numerical data*; D000367:Age Factors; D000368:Aged; D000554:Ambulatory Care Facilities / Q000706:statistics & numerical data*; D015992:Body Mass Index; D016208:Databases, Factual; D003710:Demography; D003920:Diabetes Mellitus / Q000097:blood / Q000453:epidemiology / Q000208:ethnology*; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006630:Hispanic or Latino / Q000193:education / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008489:Medical Indigency; D008875:Middle Aged; D010353:Patient Education as Topic; D014481:United States / Q000453:epidemiology; D014504:Urban Health / Q000706:statistics & numerical data; D019037:Urban Health Services / Q000706:statistics & numerical data*; D044465:White People / Q000193:education / Q000706:statistics & numerical data*
chemical_list: D006442:Glycated Hemoglobin