title: Differences in the Use and Quality of Antidiabetic Therapies in Mexican American and Non-Hispanic Whites With Uncontrolled Type 2 Diabetes in the US: NHANES 2003-2012.
abstract: The purpose of this study was to determine the use of clinical guideline-recommended antidiabetic therapies among Mexican Americans (MA) and non-Hispanic whites with uncontrolled type 2 diabetes.
  
  
  
  A secondary data analysis based on the National Health and Nutrition Examination Survey (NHANES) 2003-2012 cohort data including MA and non-Hispanic white adults with uncontrolled (A1C ≥6.5%) type 2 diabetes.
  
  
  
  There was no difference in the use of recommended regimens across race/ethnic group (MA, 63.6% vs whites, 65.7%); however, MA were less likely to have regimens intensified to non-insulin triple therapies (7.3% vs 11.3%) or insulin-based therapies (23.7% vs 30.5%) and were more likely to be on no medications (17.2% vs 10.4%). Mexican Americans and whites who were most uncontrolled were least likely to be on recommended regimens (A1C 6.5%-7.4%, 83.0%; A1C 7.5%-9%, 60.6%; and A1C >9%, 50.4%). This pattern was most pronounced among MA compared to whites. Use of recommended therapies decreased 50.5 percentage points for MA and 20.1 percentage points among whites from an A1C level of 6.5% to 7.4% to >9%, respectively.
  
  
  
  The quality of antidiabetic therapies of MA and whites with type 2 diabetes who are most uncontrolled need improvement. Intensifying pharmacotherapies among MA may help improve glycemic control disparities. The innovative outcome used in this report may be useful in quality of care studies in the future.
authors.affiliation: Nova Southeastern University College of Pharmacy, Davie, Florida (Dr Perez, Dr Sanchez)
authors.forename: Alexandra
authors.initials: A
authors.lastname: Perez
authors.affiliation: University of North Texas System College of Pharmacy, Fort Worth, Texas (Dr Elrod)
authors.forename: Shara
authors.initials: S
authors.lastname: Elrod
authors.affiliation: Nova Southeastern University College of Pharmacy, Davie, Florida (Dr Perez, Dr Sanchez)
authors.forename: Jesus
authors.initials: J
authors.lastname: Sanchez
mesh_terms: D000328:Adult; D000368:Aged; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000188:drug therapy* / Q000208:ethnology; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D008297:Male; D017058:Mexican Americans / Q000706:statistics & numerical data*; D008875:Middle Aged; D009749:Nutrition Surveys; D010342:Patient Acceptance of Health Care / Q000208:ethnology / Q000706:statistics & numerical data*; D014481:United States; D044465:White People / Q000706:statistics & numerical data*
chemical_list: D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; C517652:hemoglobin A1c protein, human