title: Race and ethnic differences in glycemic control among adults with diagnosed diabetes in the United States.
abstract: OBJECTIVE
  Control of blood glucose levels reduces vascular complications among people with diabetes, but less than half of the adults with diabetes in the United States are achieving good glycemic control. This study examines 1999-2002 national data on the association between race/ethnicity and glycemic control among adults with previously diagnosed diabetes.
  
  
  METHODS
  We analyzed data from the National Health and Nutrition Examination Survey (NHANES) 1999-2002, a cross-sectional survey of a nationally representative sample of the non-institutionalized civilian US population. Participants were non-pregnant adults, 20 years or older, with a previous diagnosis of diabetes, and who had participated in both the interview and examination in NHANES 1999-2002 (N=843). Glycemic control was determined by levels of glycosylated hemoglobin (A1C). We compared glycemic control by race/ethnicity and potential confounders including measures of socioeconomic status, obesity, healthcare access and diabetes treatment.
  
  
  RESULTS
  Overall, 44% of adults with previously diagnosed diabetes had good glycemic control (A1C levels < 7%). Mexican Americans and non-Hispanic Blacks were less likely to achieve good control (35.4% and 36.9%, respectively) compared with non-Hispanic Whites (48.6%). After multivariable adjustment for measures of socioeconomic status, obesity, healthcare access and utilization and diabetes treatment, differences in glycemic control by race/ethnicity remained.
  
  
  CONCLUSIONS
  Glycemic control is low among all racial/ethnic groups, but is lower among non-Hispanic Blacks and Mexican Americans. These results provide guidance for public health workers and health professionals in targeting programs to improve glycemic control among adults with diagnosed diabetes in the United States.
authors.affiliation: National Center for Health Statistics, Centers for Disease Control and Prevention, 3311 Toledo Road, Hyattsville, MD 20782, USA. ssaydah@cdc.gov
authors.forename: Sharon
authors.initials: S
authors.lastname: Saydah
authors.forename: Catherine
authors.initials: C
authors.lastname: Cowie
authors.forename: Mark S
authors.initials: MS
authors.lastname: Eberhardt
authors.forename: Nathalie
authors.initials: N
authors.lastname: De Rekeneire
authors.forename: K M Venkat
authors.initials: KM
authors.lastname: Narayan
mesh_terms: D000328:Adult; D000368:Aged; D044383:Black People; D001786:Blood Glucose / Q000032:analysis*; D003920:Diabetes Mellitus / Q000175:diagnosis / Q000208:ethnology* / Q000628:therapy; D005260:Female; D006442:Glycated Hemoglobin; D006630:Hispanic or Latino; D006801:Humans; D008297:Male; D008875:Middle Aged; D009749:Nutrition Surveys; D009765:Obesity; D016017:Odds Ratio; D044469:Racial Groups; D012923:Social Class; D014481:United States; D001741:Black or African American
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin