title: Racial disparities in diabetic complications in an underinsured population.
abstract: BACKGROUND
  It is unclear whether there is a racial difference in the incidence of diabetic complications in underinsured populations.
  
  
  OBJECTIVE
  The objective of the study was to investigate racial disparities in the incidence of diabetic complications within the Louisiana State University (LSU) Hospital System.
  
  
  METHODS
  This study (1997-2009) was conducted on a diabetic cohort enrolled in the LSU Hospital-Based Longitudinal Study. The cohort included 16,808 non-Hispanic white men, 21,983 non-Hispanic white women, 20,621 African-American men, and 33,753 African-American women who were 30-96 yr of age and had a mean value of family income of $9641/yr at baseline.
  
  
  RESULTS
  The study cohort had a mean follow-up of 4.4 years. The age- and sex-adjusted incidence rates and 95% confidence intervals of end-stage renal disease (ESRD), coronary heart disease (CHD), heart failure (HF), and stroke for white diabetic patients were 15.1 (14.3-15.8), 80.9 (78.9-82.9), 48.0 (46.6-49.4), and 21.4 (20.5-22.2) per 1000 person-years, respectively. Compared with white diabetic patients, African-American diabetic patients experienced higher incident rates of ESRD [17.3 (16.6-18.0)] and lower rates of CHD [47.5 (46.3-48.6)], HF [40.7 (39.6-41.8)], and stroke [19.1 (18.4-19.9)]. Female diabetic patients had lower rates of the four complications than male diabetic patients. Results of the Cox proportional hazard models confirmed sex and race disparity observed in the age-adjusted incidence rates.
  
  
  CONCLUSIONS
  Despite equal access to care, diabetic African-Americans have a higher risk of ESRD than their white counterparts, whereas diabetic whites have higher risks of CHD, HF, and stroke than their African-American counterparts.
authors.affiliation: Pennington Biomedical Research Center, 6400 Perkins Road, Baton Rouge, Louisiana 70808, USA.
authors.forename: Yujie
authors.initials: Y
authors.lastname: Wang
authors.forename: Peter T
authors.initials: PT
authors.lastname: Katzmarzyk
authors.forename: Ronald
authors.initials: R
authors.lastname: Horswell
authors.forename: Wei
authors.initials: W
authors.lastname: Li
authors.forename: Ke
authors.initials: K
authors.lastname: Xiao
authors.forename: Jay
authors.initials: J
authors.lastname: Besse
authors.forename: Wenting
authors.initials: W
authors.lastname: Xie
authors.forename: Jolene
authors.initials: J
authors.lastname: Johnson
authors.forename: Steven
authors.initials: S
authors.lastname: Heymsfield
authors.forename: Donna H
authors.initials: DH
authors.lastname: Ryan
authors.forename: Gang
authors.initials: G
authors.lastname: Hu
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D048909:Diabetes Complications / Q000453:epidemiology / Q000208:ethnology*; D005260:Female; D054624:Health Status Disparities; D054625:Healthcare Disparities / Q000208:ethnology* / Q000706:statistics & numerical data; D006801:Humans; D015994:Incidence; D007676:Kidney Failure, Chronic / Q000453:epidemiology / Q000208:ethnology; D008145:Louisiana / Q000453:epidemiology; D008297:Male; D017057:Medically Uninsured / Q000706:statistics & numerical data*; D008875:Middle Aged; D044469:Racial Groups / Q000706:statistics & numerical data; D035862:Vulnerable Populations / Q000208:ethnology / Q000706:statistics & numerical data