title: Disparities in A1C levels between Hispanic and non-Hispanic white adults with diabetes: a meta-analysis.
abstract: OBJECTIVE
  Hispanics have higher rates of diabetes and diabetes-related complications than do non-Hispanic whites. A meta-analysis was conducted to estimate the difference between the mean values of A1C for these two groups.
  
  
  METHODS
  We executed a PubMed search of articles published from 1993 through July 2007. Data sources included PubMed, Web of Science, Cumulative Index to Nursing and Allied Health, the Cochrane Library, Combined Health Information Database, and Education Resources Information Center. Data on sample size, age, sex, A1C, geographical location, and study design were extracted. Cross-sectional data and baseline data from clinical trials and cohort studies for Hispanics and non-Hispanic whites with diabetes were included. Studies were excluded if they included individuals <18 years of age or patients with pre-diabetes or gestational diabetes.
  
  
  RESULTS
  A total of 495 studies were reviewed, of which 73 contained data on A1C for Hispanics and non-Hispanic whites, and 11 met the inclusion criteria. Meta-analysis revealed a statistically significant mean difference (P < 0.0001) of -0.46 (95% CI -0.63 to -0.33), correlating to an approximately 0.5% higher A1C for Hispanics. Grouping studies by design (cross-sectional or cohort), method of data collection for A1C (chart review or blood sampling), and care type (managed or nonmanaged) yielded similar results.
  
  
  CONCLUSIONS
  In this meta-analysis, A1C was approximately 0.5% higher in Hispanic patients with diabetes than in non-Hispanic patients. Understanding the reasons for this disparity should be a focus for future research.
authors.affiliation: Department of Family and Community Medicine, Wake Forest University School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157-1084, USA. jkirk@wfubmc.edu
authors.forename: Julienne K
authors.initials: JK
authors.lastname: Kirk
authors.forename: Leah V
authors.initials: LV
authors.lastname: Passmore
authors.forename: Ronny A
authors.initials: RA
authors.lastname: Bell
authors.forename: K M Venkat
authors.initials: KM
authors.lastname: Narayan
authors.forename: Ralph B
authors.initials: RB
authors.lastname: D'Agostino
authors.forename: Thomas A
authors.initials: TA
authors.lastname: Arcury
authors.forename: Sara A
authors.initials: SA
authors.lastname: Quandt
mesh_terms: D000328:Adult; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus / Q000097:blood*; D005260:Female; D005843:Geography; D006442:Glycated Hemoglobin / Q000378:metabolism*; D006630:Hispanic or Latino; D006801:Humans; D008297:Male; D012107:Research Design; D044465:White People
chemical_list: D006442:Glycated Hemoglobin