Ethnic disparities in diabetes management: a 10-year population-based repeated cross-sectional study in UK primary care.
BACKGROUND
There has been little research on the impact of quality improvement initiatives on ethnic disparities in diabetes management in the UK.


METHODS
Population-based, repeated cross-sectional survey of recorded measurements, prescribing and achievement of treatment targets among 4309 patients with diabetes mellitus using electronic medical records from 26 general practices in North-West London from 1997 to 2006.


RESULTS
Proportions of patients having their blood pressure (BP), cholesterol and HbA1c measured and recorded increased over the study period [from 50.6% to 87.0% (P < 0.0001), 17.0% to 76.7% (P < 0.0001) and 32.9% to 74.1% (P < 0.0001), respectively]. However, some ethnic differences remained. Black patients with diabetes were less likely to achieve target BP (<140/80 mmHg) than the white group [2006 age-sex adjusted odds ratio (AOR), 0.65; 95% confidence interval (CI), 0.51-0.83]. South Asians were found to have better lipid target control (2006 AOR, 1.57; CI, 1.23-2.00), were more likely to receive oral hypoglycaemic agents (2006 AOR, 2.27; CI, 1.79-2.86) but less likely to receive insulin (2006 AOR, 0.54; CI, 0.42-0.69) than the white group.


CONCLUSIONS
Although ethnic disparities persist in diabetes management in this study population, these are starting to be addressed, particularly in the South Asian group. All ethnic groups have benefited from recent quality initiatives in the UK.
Verma
Anju
A
Department of Primary Care and Social Medicine, Imperial College Faculty of Medicine, 3rd floor Reynolds Building, St Dunstan's Road, London, UK. a.verma@imperial.ac.uk
Birger
Ruthie
R
Bhatt
Himanshu
H
Murray
Joanna
J
Millett
Christopher
C
Saxena
Sonia
S
Banarsee
Ricky
R
Gnani
Shamini
S
Majeed
Azeem
A
D001794:Blood Pressure; D002784:Cholesterol / Q000097:blood; D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus / Q000453:epidemiology / Q000208:ethnology* / Q000628:therapy*; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D008297:Male; D011320:Primary Health Care; D012307:Risk Factors; D016896:Treatment Outcome; D006113:United Kingdom / Q000453:epidemiology
D002784:Cholesterol; D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents