title: Poor glycemic control increases risk of hospitalization in urban African Americans with diabetes.
abstract: OBJECTIVE
  Hospitalizations due to diabetes are more frequent among African Americans, but risk factors are not known. We analyzed data from an urban African American patient population to identify variables associated with hospitalizations attributable principally to diabetes.
  
  
  METHODS
  Demographic, disease, and metabolic characteristics on patients seen in an outpatient diabetes clinic during 1991 to 1997 were extracted from an electronic patient tracking system. Data were linked to a statewide hospital discharge dataset to capture all in-state hospitalizations from 1998 to 2001. Persons who required a hospitalization for diabetes were compared to the remainder of individuals in the database.
  
  
  RESULTS
  A total of 3397 diabetes patients (average age 56 years; 65% women; 92% African American) were included in the analysis; 12% had a hospitalization primarily due to diabetes. Persons with a diabetes hospitalization were younger and had diabetes longer, and fewer were women. In addition, persons who had a diabetes-related hospitalization had evidence of poorer glycemic control with higher hemoglobin A1C (HbA1C) levels. Both the absolute change and rate of decline in HbA1C was less in persons who were hospitalized. In adjusted analyses, duration of diabetes and HbA1C remained significantly associated with risk of a diabetes hospitalization.
  
  
  CONCLUSIONS
  In this predominantly African American patient sample with diabetes, poorer glycemic control increased the chances of hospitalization due to diabetes. Continued efforts to aggressively control hyperglycemia could decrease the need for a diabetes hospitalization in this population.
authors.affiliation: Division of Endocrinology, Mayo Clinic, 13400 East Shea Boulevard, Scottsdale, AZ 85259, USA. Cook.Curtiss@mayo.edu
authors.forename: Curtiss B
authors.initials: CB
authors.lastname: Cook
authors.forename: Joseph G
authors.initials: JG
authors.lastname: Hentz
authors.forename: Circe
authors.initials: C
authors.lastname: Tsui
authors.forename: David C
authors.initials: DC
authors.lastname: Ziemer
authors.forename: Dorothy B
authors.initials: DB
authors.lastname: Naylor
authors.forename: William J
authors.initials: WJ
authors.lastname: Miller
mesh_terms: D000293:Adolescent; D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data*; D000368:Aged; D000419:Albuminuria / Q000652:urine; D015415:Biomarkers / Q000097:blood / Q000652:urine; D001786:Blood Glucose / Q000378:metabolism*; D001794:Blood Pressure; D008076:Cholesterol, HDL / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood; D015986:Confounding Factors, Epidemiologic; D003404:Creatinine / Q000097:blood / Q000652:urine; D003924:Diabetes Mellitus, Type 2 / Q000208:ethnology* / Q000378:metabolism / Q000503:physiopathology / Q000628:therapy*; D005260:Female; D005845:Georgia / Q000453:epidemiology; D006442:Glycated Hemoglobin / Q000378:metabolism; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D014280:Triglycerides / Q000097:blood; D014505:Urban Population / Q000706:statistics & numerical data*
chemical_list: D015415:Biomarkers; D001786:Blood Glucose; D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D003404:Creatinine; D006442:Glycated Hemoglobin; D014280:Triglycerides