Health status of New Zealand European, Maori, and Pacific patients with diabetes at 242 New Zealand general practices.
OBJECTIVE
To compare the care and health status of different ethnic groups attending general practices with diabetes.


METHODS
We analysed information about 13,281 patients with any type of diabetes, collected by 242 general practices in the first visit of the Southlink Independent Practitioner Association's Get Checked program. These patients constituted about 60% of patients with diabetes in the South Island of New Zealand.


RESULTS
13,196 (99.4%) patients had Type 1 or Type 2 diabetes. Of these, 11,911 (90.3%) were Europeans, and 759 (5.8%) were Maori or Pacific Islanders (mostly of Samoan, Tongan, Niuean, or Cook Islands origin). There was no difference between ethnic groups in total cholesterol, proportions on oral therapy or statins, or having a foot check. Maori and Pacific Islanders had poorer glycaemic control (HbA1c > 8.0 for 41.5% of Maori or Pacific Islanders versus 23.8% of New Zealand Europeans; 95% confidence interval for the difference [CI]: 14.0, 21.1), and were less likely to have retinopathy screening (71.9% versus 77.9%; CI: -9.2, -2.6). In patients with Type 2 diabetes (and compared with Europeans) Maori and Pacific Islanders were younger, had higher mean body mass indices (males 33.9 versus 29.5; CI: 3.9, 5.0 and females - 34.6 versus 30.7; CI: 3.2, 4.6) and diastolic blood pressures 82.4 mmHg versus 78.7 mmHg (CI: 2.9, 4.5), and were more likely to smoke (27.5% versus 10.9%; CI: 13.3, 19.9). Overall, Maori and Pacific Islanders were more likely to be at high risk for microvascular complications (9.0% versus 4.4%; CI: 2.5, 6.6).


CONCLUSIONS
In this study, Maori and Pacific Island patients had a demographic profile suggesting greater health vulnerability (especially for those with Type 2 diabetes) yet similar routine diabetes care (especially for those with Type 1 diabetes). Ethnic inequalities were noted in seven of nine health status measures.


CONCLUSIONS
The Get Checked program aims to increase the health of all patients with diabetes but whether it accentuates or diminishes ethnic disparities is not yet known.
Tomlin
Andrew
A
Royal New Zealand College of General Practitioners' Research Unit, Department of General Practice, Dunedin School of Medicine, University of Otago, Dunedin. andrewtomlin@hotmail.com
Tilyard
Murray
M
Dawson
Alexander
A
Dovey
Susan
S
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D017677:Age Distribution; D001786:Blood Glucose; D048909:Diabetes Complications / Q000208:ethnology; D003920:Diabetes Mellitus / Q000097:blood / Q000208:ethnology / Q000628:therapy; D005194:Family Practice; D006442:Glycated Hemoglobin / Q000032:analysis; D006304:Health Status; D009520:New Zealand / Q000453:epidemiology; D044465:White People; D000095188:Pacific Island People; D000095284:Maori People
D001786:Blood Glucose; D006442:Glycated Hemoglobin