Kirk Julienne K, Bell Ronny A, Bertoni Alain G, Arcury Thomas A, Quandt Sara A, Goff David C, Narayan K M Venkat
Department of Family and Community Medicine, Wake Forest University School of Medicine, Winston-Salem, NC 27157-1084, USA.
Ann Pharmacother. 2005 Sep;39(9):1489-501. doi: 10.1345/aph.1E685. Epub 2005 Aug 2.
To examine ethnic disparities in the quality of diabetes care among adults with diabetes in the US through a systematic qualitative review.
Material published in the English language was searched from 1993 through June 2003 using PubMed, Web of Science, Cumulative Index to Nursing and Allied Health, the Cochrane Library, Combined Health Information Database, and Education Resources Information Center.
Studies of patients with diabetes in which at least 50% of study participants were ethnic minorities and studies that made ethnic group comparisons were eligible. Research on individuals having prediabetes, those <18 years of age, or women with gestational diabetes were excluded. Reviewers used a reproducible search strategy. A standardized abstraction and grading of articles for publication source and content were used. Data on glycemia, blood pressure, and low-density lipoprotein cholesterol (LDL-C) were extracted in patients with diabetes. A total of 390 studies were reviewed, with 78 meeting inclusion criteria.
Ethnic minorities had poorer outcomes of care than non-Hispanic whites. These disparities were most pronounced for glycemic control and least evident for LDL-C control. Most studies showed blood pressure to be poorly controlled among ethnic minorities.
Control of risk factors for diabetes (glycemia, blood pressure, LDL-C) is challenging and requires routine assessment. These findings indicate that additional efforts are needed to promote diabetes quality of care among minority populations.
通过系统的定性综述，研究美国成年糖尿病患者在糖尿病护理质量方面的种族差异。
使用PubMed、科学网、护理及相关健康累积索引、考克兰图书馆、联合健康信息数据库和教育资源信息中心，检索1993年至2003年6月以英文发表的资料。
研究对象至少50%为少数族裔的糖尿病患者研究以及进行种族比较的研究符合要求。排除对糖尿病前期个体、18岁以下个体或妊娠糖尿病女性的研究。评审人员采用可重复的检索策略。对文章的发表来源和内容进行标准化的摘要和分级。提取糖尿病患者的血糖、血压和低密度脂蛋白胆固醇（LDL-C）数据。共评审390项研究，78项符合纳入标准。
少数族裔的护理结局比非西班牙裔白人差。这些差异在血糖控制方面最为明显，在LDL-C控制方面最不明显。大多数研究表明少数族裔的血压控制不佳。
控制糖尿病风险因素（血糖、血压、LDL-C）具有挑战性，需要进行常规评估。这些发现表明，需要做出更多努力来提高少数族裔人群的糖尿病护理质量。
