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J R Soc Med. 2012 Jul;105(7):300-8. doi: 10.1258/jrsm.2012.110289. Epub 2012 Mar 6.

Ethnic and social disparity in glycaemic control in type 2 diabetes; cohort study in general practice 2004-9.

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  • 1Centre for Primary Care and Public Health, St Barts and London Hospital School of Medicine, Queen Mary University of London, 58 Turner Street, London E1 2AB, UK.

Abstract

OBJECTIVE:

To determine whether ethnic group differences in glycated haemoglobin (HbA1c) changed over a 5-year period in people on medication for type 2 diabetes.

DESIGN:

Open cohort in 2004-9.

SETTING:

Electronic records of 100 of the 101 general practices in two inner London boroughs.

PARTICIPANTS:

People aged 35 to 74 years on medication for type 2 diabetes.

MAIN OUTCOME MEASURES:

Mean HbA1c and proportion with HbA1c controlled to ≤ 7.5%.

RESULTS:

In this cohort of 24,111 people, 22% were White, 58% South Asian and 17% Black African/Caribbean. From 2004 to 2009 mean HbA1c improved from 8.2% to 7.8% for White, from 8.5% to 8.0% for Black African/Caribbean and from 8.5% to 8.0% for South Asian people. The proportion with HbA1c controlled to 7.5% or less, increased from 44% to 56% in White, 38% to 53% in Black African/Caribbean and 34% to 48% in South Asian people. Ethnic group and social deprivation were independently associated with HbA1c. South Asian and Black African/Caribbean people were treated more intensively than White people.

CONCLUSION:

HbA1c control improved for all ethnic groups between 2004-9. However, South Asian and Black African/Caribbean people had persistently worse control despite more intensive treatment and significantly more improvement than White people. Higher social deprivation was independently associated with worse control.

PMID:
22396467
[PubMed - indexed for MEDLINE]
PMCID:
PMC3407404
Free PMC Article

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