title: Racial disparities in lipid control in patients with diabetes.
abstract: To describe lipid management over time in a cohort of insured patients with diabetes and evaluate differences between African American and white patients.
  
  
  
  Automated claims data were used to identify a cohort of 11,411 patients with diabetes in 1997 to 1998. Patients were followed through 2007.
  
  
  
  Rates of hypercholesterolemia testing, treatment, and goal attainment were measured annually. Treatment was determined by a claim for lipid-lowering agents, and goal attainment was defined as a low-density lipoprotein cholesterol (LDL-C) level <100 mg/dL.
  
  
  
  During the study period, LDL-C testing increased from 48% to 70% among African American patients and from 61% to 77% among white patients. Treatment with lipid-lowering drugs increased from 23% to 56% among African American patients and 33% to 61% among white patients. The proportion at goal increased from 35% to 76% and from 24% to 59% among white and African American patients, respectively. African American patients were less likely to be tested for LDL-C (odds ratio [OR] 0.79; 95% confidence interval [CI] 0.73-0.86), treated with lipidlowering agents (OR 0.72; 95% CI 0.65-0.80), have their medication dosage altered (OR 0.65; 95% CI 0.59-0.73), or attain LDL-C goal (OR 0.59; 95% CI 0.56-0.63) compared with white patients.
  
  
  
  Although rates of LDL-C testing, treatment, and goal attainment improved over time, racial disparities in dyslipidemia management continued to exist. Further studies to determine the causes of differences in management by race are warranted.
authors: Institute on Multicultural Health, Henry Ford Health System, Detroit, MI, USA. darcy.saffar@va.gov
authors: Darcy
authors: D
authors: Saffar
authors: Keoki
authors: K
authors: Williams
authors: Jennifer Elston
authors: JE
authors: Lafata
authors: George
authors: G
authors: Divine
authors: Manel
authors: M
authors: Pladevall
mesh_terms: D001741:Black or African American / Q000706:statistics & numerical data; D008078:Cholesterol, LDL / Q000097:blood; D016001:Confidence Intervals; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000453:epidemiology; D019468:Disease Management; D054624:Health Status Disparities; D006801:Humans; D006949:Hyperlipidemias / Q000097:blood / Q000188:drug therapy / Q000208:ethnology*; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D000960:Hypolipidemic Agents / Q000627:therapeutic use; D007345:Insurance Claim Review; D008055:Lipids / Q000097:blood*; D055118:Medication Adherence; D015999:Multivariate Analysis; D016017:Odds Ratio; D014481:United States / Q000453:epidemiology
chemical_list: D008078:Cholesterol, LDL; D007004:Hypoglycemic Agents; D000960:Hypolipidemic Agents; D008055:Lipids