Racial and Gender Differences in HgbA1c and LDL-C Goal Attainment in Patients with Diabetes

Program: Abstracts - Orals, Featured Poster Presentations, and Posters
Session: SUN 807-838-Diabetes - Diagnosis, Complications & Outcomes
Clinical
Sunday, June 16, 2013: 1:45 PM-3:45 PM
Expo Halls ABC (Moscone Center)

Poster Board SUN-816
Pendar Farahani*1, Abraham Thomas2 and Jennifer Elston-Lafata3
1Henry Ford Hospital, Detroit, MI, 2Henry Ford Med Ctr, Detroit, MI, 3Virginia Commonwealth University, Richmond, VA
Objective:

To explore the level of attainment of HgA1c and LDL-C goals in patients with diabetes by gender and race.

Methods:

A cohort of patients with diabetes was constructed from an electronic medical record of an integrated health system in Southeast Michigan. Demographic, HgbA1c, and LDL-C data were obtained and an analysis was conducted for goal attainment of HgA1c and LDL-C according to race and gender, between African American (AA) patients and Caucasian (C) patients.

Results:

The cohort contained 7,458 patients, [Male (M)=3,768, Female (F)=3,690]. In this cohort, there were 820 AA (M=398, F=422) and 1169 C (M=652, F=517). BMI [mean (SD), 33(7)] was not significantly different by gender or race, However, AA were significantly younger than C [61(13) vs 66(12) years, P=0.0001]. The mean HgbA1c in AA was 7.8(1.8)% and C was 7.2(1.2)%, P=0.0001. The proportion of patients who achieved an HgbA1c under 7.0% were as follows: AA 39% (M=37% vs F=40%, P>0.05), C 54% (M=53% vs F=54%, P>0.05) with a significant difference between AA and C, p=0.0001. The proportion of patients who achieved HgbA1c under 8.0% were as follows:  AA 63% (M=60% vs F=66%, P=0.08); C 79% (M=78% vs F=81%, P>0.05) with a significant difference between AA and C, p=0.0001. The mean LDL-C (mg/dl) in AA was 98(35) and C 87(31) with a significant difference between AA and C, P=0.0001. The proportions of patients who achieved LDL-C under 70 mg/dl were as follows: AA 22% (M=25% vs F=18%, P=0.013); C 34% (M=40% vs F=28%, P=0.0001), with a significant difference between AA and C, P=0.0001. The proportions of patients who achieved LDL-C under 100 mg/dl were as follows: AA 58% (M=61% vs F=55%, P= 0.08); C 74% (M=78% vs F=69%, P=0.0006), with a significant difference between AA and C, P=0.0001.

Conclusion:

In this insured cohort of patients with diabetes a large proportion of patients did not attain HgbA1c and LDL-C goals regardless of gender or race. Differences in LDL-C goal attainment were present among patients enrolled in this cohort by both gender and race. Regarding HgbA1c goal attainment, significant differences were observed for race, but not for gender. The observed lower LDL-C goal attainment in women of both races may suggest the possibility of less intensive cholesterol treatment in women. The differences in the pattern of HgbA1c and LDL-C goal attainment call for the need for further study to determine other possible health disparities and tailor interventions to address the impact of gender and race.

Nothing to Disclose: PF, AT, JE

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