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Black Diabetics Have Higher Glycosylated Hemoglobin

Further intervention needed to help patients manage disease

THURSDAY, Dec. 22 (HealthDay News) -- Black diabetics have higher levels of glycosylated hemoglobin than white diabetics, but this does not appear to be due to quality of care, according to a study published in the December issue of Diabetes Care.

Alyce S. Adams, Ph.D., of Harvard Medical School and Harvard Pilgrim Health Care in Boston, and colleagues analyzed data from black and white diabetics at a single practice insured by a single health maintenance organization. The researchers looked at the average annual glycosylated hemoglobin levels (A1C) in 1,686 patients who were diagnosed with diabetes before 1994, and 1,280 diabetics who were diagnosed between 1994 and 1997. Patients were followed for four to eight years.

Blacks and whites had similar baseline rates of A1C testing and physician visits, but blacks had higher unadjusted A1C values. In the group previously diagnosed with diabetes, the researchers found that average A1C values were significantly higher in black women compared with white women, with a difference of 0.30. In patients with newly diagnosed diabetes, black men had significantly higher average A1C values than white men, with a difference of 0.49.

"Factors other than the quality of care may explain persistent race differences in A1C in this setting," Adams and colleagues conclude. "Future interventions should target normalization of A1C by identifying potential psychosocial barriers to therapy intensification among patients and clinicians and development of culturally appropriate interventions to aid patients in successful self-management."

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