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Why the Ethnic Disparity in A1c's?

Linda von Wartburg

Dec 5, 2007

Hispanics and African Americans have higher A1c's than whites. That disparity contributes to the unfortunate fact that in the U.S., approximately ten percent of racial differences in mortality have been attributed to diabetes.

The reason for that sad statistic was the subject of a recent study by researchers from the University of Michigan, who sent detailed questionnaires to 1,901 African American, Latino, and white people with diabetes aged 55 and older.

The researchers found that among the participants taking diabetes medications, Latinos had an average A1c of 8.14%, African Americans averaged 8.07%, and whites averaged 7.22%. An even bigger disparity was found among the participants who were between 55 and 64, too young for Medicare. Those African Americans had average A1c's of 8.96%, compared to Latinos at 8.91% and whites at 7.46%.

In searching for explanations, the researchers looked into the subjects' education level, household income, mental health, insurance coverage, quality of health care, medication regimens, exercise, and diet. They also looked at their emotional responses to diabetes and how well they took their prescribed diabetes medications.

The researchers learned that Latinos are more likely than whites to experience diabetes-related emotional distress. African-Americans, on the other hand, are less likely to take their prescribed medicines. According to the current findings, differences in income and education level did not contribute to the glucose control differences. In fact, all the surveyed factors accounted for only fourteen percent of the African American disparity and nineteen percent of the Latino disparity.

The authors concluded that unassessed factors, such as genetics, stress levels and other environmental factors, intensity of medication regimens, and quality of insurance coverage, must account for the remaining over eighty percent of disparity in A1c's among the three groups.

Sources: WebMD, University of Michigan news release, Science Daily; Archives of Internal Medicine, September 2007

Editor's Note: Did they look at access to diabetes education programs?

Categories: A1c Test, Diabetes, Diabetes, Professional Issues

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Dec 5, 2007

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Why the Ethnic Disparity in A1c's?

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