Lasater L M, Davidson A J, Steiner J F, Mehler P S
Denver Health, 777 Bannock St, Mail Code 0148, Denver, CO 80204, USA.
Arch Intern Med. 2001 Jan 8;161(1):77-82. doi: 10.1001/archinte.161.1.77.
Hispanic individuals compose the fastest growing minority group in the United States, yet little is known about how language impacts their health care. The primary objective of this study was to determine whether the inability to speak English adversely affected glycemic control in Hispanic patients with type 2 diabetes mellitus.
This retrospective cohort study selected 183 Hispanic patients with type 2 diabetes mellitus aged 35 to 70 years from a public health care system; patients were Spanish-speaking (SS) only, and control patients were English-speaking (ES) or bilingual. Clinical information was collected via telephone survey, and data on health care use, diagnosis, and glycosylated hemoglobin A(1c) (HbA(1c)) values were obtained from administrative and laboratory information systems.
Values of HbA(1c) for SS (mean, 9.1%; range, 5.0%-15.3%) and ES (mean, 9.0%; range, 4.9%-16.2%) patients with diabetes mellitus and the total number of hospitalizations related and unrelated to diabetes mellitus did not differ (P =.86). Spanish-speaking patients had a diagnosis of diabetes mellitus for fewer years than ES patients (8.2 and 11.2 years, respectively; P =. 01). Spanish-speaking patients were less likely to understand their prescriptions; 22% of SS patients reported no comprehension vs 3% of ES patients (P =.001). There was a trend toward decreased prevalence of insulin use among SS patients compared with ES patients (30% vs 42%, respectively; P =.07).
Glycemic control in Hispanic patients was not related to their ability to speak English. This finding may be explained by a high degree of language concordance between patients and providers.
西班牙裔个体是美国增长最快的少数族裔群体，但对于语言如何影响他们的医疗保健情况却知之甚少。本研究的主要目的是确定无法说英语是否会对西班牙裔2型糖尿病患者的血糖控制产生不利影响。
这项回顾性队列研究从一个公共卫生保健系统中选取了183名年龄在35至70岁之间的西班牙裔2型糖尿病患者；患者仅说西班牙语（SS），对照患者说英语（ES）或双语。通过电话调查收集临床信息，并从行政和实验室信息系统中获取有关医疗保健使用、诊断和糖化血红蛋白A1c（HbA1c）值的数据。
糖尿病患者中，说西班牙语（SS）患者（平均9.1%；范围5.0%-15.3%）和说英语（ES）患者（平均9.0%；范围4.9%-16.2%）的HbA1c值以及与糖尿病相关和不相关的住院总数并无差异（P = 0.86）。说西班牙语的患者被诊断患有糖尿病的时间比说英语的患者短（分别为8.2年和11.2年；P = 0.01）。说西班牙语的患者理解其处方的可能性较小；22%的SS患者表示不理解，而ES患者中这一比例为3%（P = 0.001）。与ES患者相比，SS患者使用胰岛素的患病率有下降趋势（分别为30%和42%；P = 0.07）。
西班牙裔患者的血糖控制与其说英语的能力无关。这一发现可能是由于患者与医疗服务提供者之间高度的语言一致性所致。
