Prevalence and care of diabetes mellitus in the Medicare population of North Carolina. Baseline findings from the Medicare Healthcare Quality Improvement Program.

OBJECTIVE

To describe diabetes and its care in the Medicare population of North Carolina.

STUDY DESIGN

Cross-sectional.

DATA SOURCE/STUDY SETTING: Medicare claims for North Carolina residents 18 to 75 years of age were reviewed to characterize diabetes prevalence during the late 1990s and to evaluate adherence to diabetes clinical practice recommendations.

PRINCIPAL FINDINGS

Almost 84,000 persons with diabetes and Medicare were identified. Diabetes prevalence was 15.0% overall, 22.9% among African Americans, and 12.9% among Caucasians. A "diabetes belt" of relatively high prevalence was noted in the eastern coastal plain. Glycated hemoglobin testing, lipid testing, and retinopathy screening were performed at about half the recommended rate. Diabetes care rates were lower for African Americans than for Caucasians.

CONCLUSIONS

Diabetes is a common and under-treated condition in the Medicare population of North Carolina, especially among African Americans.

RELEVANCE

There is much room for improvement in diabetes care within one of North Carolina's most vulnerable populations, the disabled and elderly enrolled in Medicare. Substantial public health opportunities exist in the identification and removal of barriers to diabetes care.