Evolving demographics and disparities in an urban diabetes clinic: implications for diabetes education and treatment.
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.
Dunbar
Virginia G
VG
Grady Health System, Atlanta, Georgia, USA.
King
Esther C
EC
George
Christopher D
CD
El-Kebbi
Imad M
IM
Ziemer
David C
DC
Gallina
Daniel L
DL
Cook
Curtiss B
CB
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*
D006442:Glycated Hemoglobin