More diabetes, hyperglycemia, complications found in black inpatients
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Racial disparities in diabetes care and outcomes are apparent in hospitalized white and black patients, according to recent research.
Guillermo E. Umpierrez, MD, of Emory University, and colleagues evaluated data on 35,866 adults (40.1% black) admitted to medical and surgery services in two academic hospitals between 2012 and 2013 to determine associations between hyperglycemia and complications in adults with and without diabetes among different racial groups.
Diabetes (P < .0001) and hyperglycemia (P < .0001) were found more often among black patients (34.5% with diabetes; 42.3% with hyperglycemia) compared with white patients (22.8% with diabetes; 36.7% with hyperglycemia).
HbA1c was higher in black patients compared with whites (P < .0001), and 38.1% of black patients received insulin therapy compared with 33% of white patients (P < .0001).
The risks for pneumonia, bacteremia, myocardial infarction, respiratory failure, acute kidney injury and death were greater among black patients compared with white patients.
After adjustment for age, sex, BMI, comorbidities and insurance coverage, compared with white patients, more complications were found among black patients without diabetes with normoglycemia (OR = 1.22; 95% CI, 1.1-1.35) and black patients without diabetes with hyperglycemia (OR = 1.18; 95% CI, 1.04-1.33).
“We report the presence of racial disparities in inpatient care, with black patients having a higher frequency of diabetes and hyperglycemia, worse glycemic control and higher hospital complications compared to white patients,” the researchers wrote. “We also identified nondiabetic blacks with hyperglycemia as a particularly vulnerable group. Understanding the predisposing vulnerability of racial and ethnic minorities can help us to direct concerted efforts to help narrow disparities in health care.” – by Amber Cox
Disclosure: Umpierrez reports receiving consulting fees and/or honoraria for membership in advisory boards from Boehringer Ingelheim, Merck, Novo Nordisk, Regeneron and Sanofi. Please see the full study for a list of all other authors’ relevant financial disclosures.