title: The quality of diabetes care to Gullah families of South Carolina.
abstract: Empirical evidence from the Diabetes Control and Complication Trial (DCCT) suggests that maintaining normal glycemic control can prevent both micro vascular and macro vascular diseases in persons diagnosed with type 2 diabetes mellitus (T2DM) (DCCT, 1993). Adults with T2DM are also more likely to have hypertension (73% [HTN]) and patients with both are 2 to 4 times more likely to develop diabetic complications compared with the general population (CDC, 2005). The purpose of this descriptive study was to 1) describe the quality of diabetes care received by Gullah families who participated in the Project SuGar research study; and 2) compare the Gullah's quality of care to the national sample in the Center for Disease Control (CDC) Diabetes Report Card using the two indicators of blood pressure and HbA1c. This was a secondary analysis from a parent study that compared selected data to the CDC Diabetes Report Card, the National Health and Nutrition Examination Survey (NHANES III), and the Behavioral Risk Factor Surveillance System (BRFSS). Socio-demographic and clinical data were obtained from 1,057 research participants (N = 1,057). Overall, when compared to the national sample in the CDC Report Card, the HbA1c greater than 9.5% mg/dL was higher among the Gullahs, (30.2% vs. 18%), and blood pressure greater 140/90 mmHg was lower (29% vs. 34%) among the participants. Almost half of the Gullahs (45.9%) self-reported neurovascular complications such as foot pain, claudication, and renal complications of kidney infection and dialysis (7.3%). The Gullah study participants are at risk for diabetes-related complications. Results suggest a quality gap in diabetes care and it suggests health disparities in outcome measures as well. Optimal care that is consistent with clinical guidelines could have a significant impact on decreasing complications and health disparities.
authors.affiliation: Clinical Genetics, College of Nursing, University of Iowa, 50 Newton Road, 305 Nursing Building, Iowa City, IA 52242-1121, USA. ispruill@yahoo.com
authors.forename: Ida
authors.initials: I
authors.lastname: Johnson-Spruill
authors.forename: Barbara
authors.initials: B
authors.lastname: Riegel
mesh_terms: D044383:Black People; D002487:Centers for Disease Control and Prevention, U.S.; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000208:ethnology / Q000628:therapy*; D005006:Ethnicity; D006801:Humans; D006973:Hypertension / Q000150:complications; D011787:Quality of Health Care; D013022:South Carolina; D014481:United States; D001741:Black or African American