LeMaster Joseph William, Chanetsa Fungai, Kapp Julie M, Waterman Brian M
Department of Family and Community Medicine, University of Missouri-Columbia School of Medicine, M241A Health Sciences Bldg DC032.00, Columbia, MO 65212, USA.
Prev Chronic Dis. 2006 Jul;3(3):A86. Epub 2006 Jun 15.
Racial disparities exist in the rates of diabetes complications in the United States and in the state of Missouri. It is unclear to what degree such disparities involve diabetes-related preventive care. We sought evidence for racial disparities in diabetes-related preventive care between non-Hispanic blacks and whites in Missouri.
We analyzed data from the Missouri Behavioral Risk Factor Surveillance System from 1994 through 2002. This state-specific survey is conducted annually among a representative sample of Missourians. We examined data from 842 Missourians who reported a diagnosis of type 1 or type 2 diabetes and who had consulted a health professional in the 12 months before they were interviewed. We analyzed reported receipt of glycosylated hemoglobin testing, foot examinations, and dilated eye examinations in the year before interview.
Non-Hispanic blacks were significantly less likely than whites to report having had glycosylated hemoglobin testing (odds ratio [OR], 0.47; 95% confidence interval [CI], 0.22-0.99) but more likely to report having received foot examinations (OR, 1.99; 95% CI, 1.21-2.39). There was no difference between blacks and whites in the probability of dilated eye examinations (OR, 1.49; 95% CI, 0.94-2.36).
Compared with whites, non-Hispanic blacks in Missouri receive adequate screening for diabetic complications but not for glycemic control. Further studies are needed to investigate whether these disparities are linked to differences in the rate of diabetes complications in Missouri.
在美国及密苏里州,糖尿病并发症发生率存在种族差异。目前尚不清楚此类差异在多大程度上与糖尿病相关的预防保健有关。我们旨在寻找密苏里州非西班牙裔黑人和白人在糖尿病相关预防保健方面存在种族差异的证据。
我们分析了1994年至2002年密苏里行为危险因素监测系统的数据。这项针对该州的调查每年对具有代表性的密苏里人样本进行。我们研究了842名报告患有1型或2型糖尿病且在接受访谈前12个月内咨询过健康专业人员的密苏里人的数据。我们分析了受访者在访谈前一年报告的糖化血红蛋白检测、足部检查和散瞳眼科检查的接受情况。
非西班牙裔黑人报告进行糖化血红蛋白检测的可能性显著低于白人(优势比[OR],0.47;95%置信区间[CI],0.22 - 0.99),但报告接受足部检查的可能性更高(OR,1.99;95% CI,1.21 - 2.39)。黑人和白人在散瞳眼科检查的概率上没有差异(OR,1.49;95% CI,0.94 - 2.36)。
与白人相比,密苏里州的非西班牙裔黑人接受了充分的糖尿病并发症筛查,但血糖控制方面的筛查不足。需要进一步研究来调查这些差异是否与密苏里州糖尿病并发症发生率的差异有关。