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- Title
Report on Racial Disparities in Hospitalized Patients with Hyperglycemia and Diabetes.
- Authors
Fayfman, Maya; Vellanki, Priyathama; Alexopoulos, Anastasia-Stefania; Buehler, Lauren; Zhao, Liping; Smiley, Dawn; Haw, Sonya; Weaver, Jeff; Pasquel, Francisco J; Umpierrez, Guillermo E
- Abstract
<bold>Context: </bold>A higher prevalence of diabetes-related complications is reported in minority populations; however, it is not known if there are racial disparities in diabetes care and outcomes in hospitalized patients.<bold>Objective: </bold>Our objective was to determine the association between hyperglycemia, in patients with and without diabetes mellitus (non-DM), and complications among different racial groups.<bold>Design: </bold>This observational study compared the frequency of hyperglycemia (blood glucose ≥ 180 mg/dL; 10 mmol/L) and DM and hospital complications between Black and White patients hospitalized patients between January 2012 and December 2013.<bold>Setting and Participants: </bold>Adults admitted to medical and surgery services in two academic hospitals were included in this study.<bold>Results: </bold>Among 35 866 patients, there were 14 387 Black (40.1%) and 21 479 White patients (59.9%). Blacks had a higher prevalence of hyperglycemia (42.3% vs 36.7%, P < .0001) and DM (34.5% vs 22.8%, P < .0001) and a higher admission rate and mean daily blood glucose (P < .001). Blacks also had higher rates of complications (22.2% vs 19.2%, P < .0001), both in patients with DM (24.7 vs 22.9%, P = .0413) and non-DM with hyperglycemia (41.2% vs 37.2%, P = .0019). Using sequential modelling adjusted for age, gender, body mass index, comorbidities, and insurance coverage, non-DM Blacks with normoglycemia (odds ratio, 1.22; 95% confidence interval, 1.10-1.35) and non-DM Blacks with hyperglycemia (odds ratio, 1.18; 95% confidence interval, 1.04-1.33) had higher number of complications compared to Whites.<bold>Conclusions: </bold>Black patients have higher rates of hyperglycemia and diabetes, worse inpatient glycemic control, and greater frequency of hospital complications compared to Whites. Non-DM Blacks with hyperglycemia are a particularly vulnerable group. Further investigation is needed to better understand factors contributing the racial disparities in the hospital.
- Subjects
DIABETES complications; STATISTICS on Black people; BLOOD sugar; DIABETES; HEALTH services accessibility; HEALTH status indicators; HOSPITAL care; HYPERGLYCEMIA; POPULATION; RESEARCH funding; WHITE people; DISEASE prevalence; DISEASE complications
- Publication
Journal of Clinical Endocrinology & Metabolism, 2016, Vol 101, Issue 3, p1144
- ISSN
0021-972X
- Publication type
journal article
- DOI
10.1210/jc.2015-3220