title: Regional Variation in Diabetic Outcomes by Country-of-Origin and Language in an Urban Safety Net Hospital.
abstract: Adherence to diabetic care guidelines among US immigrants remains low. This study assesses adherence to diabetic care guidelines by country-of-origin and language among a limited English-proficient (LEP) population. Timely completion of diabetic measures and acceptable levels of hemoglobin A1c (A1c), low density lipoprotein (LDL) cholesterol, and blood pressure (BP) were compared between LEP and English-proficient (EP) patients in this 2013 retrospective cohort study of adult diabetics. More LEP patients met BP targets (83 vs. 68 %, p < 0.0001) and obtained LDL targets (89 vs. 85 %, p = 0.0007); however, they had worse LDL control (57 vs. 62 %, p = 0.0011). Ethiopians and Somalians [adjusted OR (95 % CI) = 0.44 (0.30, 0.63)] were less likely than Latin Americans to meet BP goals. LEP patients outperformed EP peers on several diabetic outcomes measures with important variation between groups. These data highlight the success of a safety net hospital in improving diabetes management among diverse populations.
authors: United Family Medicine Residency Program, Saint Paul, MN, USA.
authors: April K
authors: AK
authors: Wilhelm
authors: Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, MN, USA.
authors: Debra J
authors: DJ
authors: Jacobson
authors: Minneapolis Medical Research Foundation, 701 Park Avenue South (P7), Minneapolis, MN, 55415, USA. Laura.Guzman-Corrales@hcmed.org.
authors: Laura
authors: L
authors: Guzman-Corrales
authors: Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, MN, USA.
authors: Chun
authors: C
authors: Fan
authors: Analytic Center of Excellence, Hennepin County Medical Center, Minneapolis, MN, USA.
authors: Karen
authors: K
authors: Baker
authors: Division of Primary Care Internal Medicine, Mayo Clinic, Rochester, MN, USA.
authors: Jane W
authors: JW
authors: Njeru
authors: Division of Primary Care Internal Medicine, Mayo Clinic, Rochester, MN, USA.
authors: Mark L
authors: ML
authors: Wieland
authors: Minneapolis Medical Research Foundation, 701 Park Avenue South (P7), Minneapolis, MN, 55415, USA.
authors: Deborah H
authors: DH
authors: Boehm
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003144:Communication Barriers; D003920:Diabetes Mellitus / Q000208:ethnology / Q000628:therapy; D054242:Emigrants and Immigrants / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007802:Language; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D064876:Safety-net Providers / Q000706:statistics & numerical data*; D016896:Treatment Outcome; D014481:United States; D055815:Young Adult
keywords: Diabetes; Immigrant; Interpreter use; Limited English language proficiency