Disparities in self-monitoring of blood glucose among low-income ethnic minority populations with diabetes, United States.
BACKGROUND
In adults with insulin-treated diabetes, self-monitoring of blood glucose (SMBG) rates may be lower in minority or low-income populations, but the effect of income on racial/ethnic differences in SMBG is unknown.


METHODS
We assessed whether racial/ethnic differences in SMBG vary by income among adults with insulin-treated diabetes by using Behavioral Risk Factor Surveillance System data from 2000 through 2004. We measured the prevalence of SMBG at least once per day among 16,630 adults aged > or = 19 years with insulin-treated diabetes.


RESULTS
At incomes > or = $20,000, Hispanics and non-Hispanic Blacks reported similar but lower SMBG rates than did non-Hispanic Whites (78%, 77%, 85%; P < or = .01). However, among those with income < $20,000, Hispanics performed SMBG substantially less than did Blacks or Whites (65%, 79%, 85%; P < or = .01). Racial/ ethnic differences in SMBC persisted after adjustment for age, sex, education, health insurance, health status, survey period, and diabetes measures. Receipt of diabetes education varied significantly by race/ethnicity in the income < $20,000 group only (Hispanics 49%, Blacks 64%, Whites 62%; P < .001). Low-income Hispanics with limited English proficiency had lower SMBG and diabetes education rates than did those with English proficiency (61% vs 79% and 44% vs 58%, respectively).


CONCLUSIONS
Among US adults with insulin-treated diabetes, Hispanics and Blacks performed daily SMBG less frequently than did Whites. Stratification by income revealed a disparity gradient in the income < $20,000 group: SMBG rates decreased from Whites to Blacks to Hispanics. Low-income Hispanics with limited English proficiency are at greater risk for reduced SMBG than are those proficient in English.
Levine
Deborah A
DA
Division of General Internal Medicine, College of Medicine, Ohio State University; 466 Cunz Hall, 1841 Neil Ave, Columbus, OH 43210, USA. dlevine@cph.osu.edu
Allison
Jeroan J
JJ
Cherrington
Andrea
A
Richman
Joshua
J
Scarinci
Isabel C
IC
Houston
Thomas K
TK
D000293:Adolescent; D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data*; D000368:Aged; D040343:Behavioral Risk Factor Surveillance System; D015190:Blood Glucose Self-Monitoring / Q000191:economics / Q000706:statistics & numerical data*; D005260:Female; D054625:Healthcare Disparities / Q000191:economics*; D006630:Hispanic or Latino / Q000706:statistics & numerical data*; D006801:Humans; D007182:Income; D008297:Male; D008875:Middle Aged; D008913:Minority Groups / Q000706:statistics & numerical data*; D011203:Poverty / Q000706:statistics & numerical data; D014481:United States / Q000453:epidemiology; D044465:White People / Q000706:statistics & numerical data*; D055815:Young Adult