Racial/ethnic disparities in the management of diabetes

This study estimates racial/ethnic disparities in the diagnosis of diabetes, as well as racial/ethnic disparities in glycemic control among diagnosed diabetics, using US survey data. The study also explores recent trends in racial/ethnic disparities in these health outcomes. Data come from two national surveys: the National Health and Nutrition Examination Survey (NHANES), 1988-1994 and 1999-2008; and the Health and Retirement Study (HRS), 2006. We use probit models adjusted for complex survey design to estimate racial/ethnic disparities in: (1) diagnosis of diabetes among those with diagnosed or undiagnosed diabetes; and (2) glycemic control among those who have diagnosed diabetes. We find that among respondents with diagnosed or undiagnosed diabetes, other races/ethnicities were 18 percentage points less likely to be diagnosed with diabetes compared to non-Latino whites in the 1988-1994 NHANES. However, in the 1999-2008 NHANES, there were no longer racial/ethnic disparities in diagnosis of diabetes. Racial/ethnic disparities in glycemic control among diabetes were statistically insignificant in the 1988-1994 NHANES. However, in the1999-2008 NHANES, African Americans and Latinos with diagnosed diabetes were 10 percentage points less likely to have glycemic control compared similar non-Latino whites with diagnosed diabetes. Similarly, data from the 2006 HRS also show that racial/ethnic disparities in diagnosis of diabetes are insignificant, but there remain significant racial/ethnic disparities in glycemic control. The findings suggest that racial/ethnic disparities in the diagnosis of diabetes have improved over time, but there remains striking disparities in adequate control of the disease.