High rates of severe hypoglycemia among African American patients with diabetes: the surveillance, prevention, and Management of Diabetes Mellitus (SUPREME-DM) network

Autor: Katherine M. Newton, Patrick J. O'Connor, Jean M. Lawrence, Melissa G. Butler, Jay Desai, Abraham Thomas, Beth E. Waitzfelder, Emily B. Schroeder, Kasia J. Lipska, Gregory A. Nichols, Howard H. Moffet, Jennifer Y. Liu, Andrew J. Karter, John F. Steiner, Ram D. Pathak
Rok vydání: 2017
Předmět:
Adult
Male
Gerontology
Adolescent
Endocrinology
Diabetes and Metabolism
medicine.medical_treatment
Population
Ethnic group
030209 endocrinology & metabolism
Hypoglycemia
Severity of Illness Index
Article
Cohort Studies
Young Adult
03 medical and health sciences
Sex Factors
0302 clinical medicine
Endocrinology
Risk Factors
Diabetes mellitus
Diabetes Mellitus
Internal Medicine
medicine
Humans
030212 general & internal medicine
education
Retrospective Studies
African american
education.field_of_study
Delivery of Health Care
Integrated
business.industry
Insulin
Managed Care Programs
Age Factors
Health Status Disparities
Emergency department
Middle Aged
medicine.disease
Combined Modality Therapy
United States
Annual Percent Change
Black or African American
Population Surveillance
Female
business
Demography
Zdroj: Journal of Diabetes and its Complications. 31:869-873
ISSN: 1056-8727
DOI: 10.1016/j.jdiacomp.2017.02.009
Popis: Seven-year surveillance study (2005-2011) to evaluate race/ethnic differences in the trends in rates of severe hypoglycemia (SH) in a population of insured, at-risk adults with diabetes.SH events were identified via any primary or principal diagnosis from emergency department or inpatient encounters among African American, Asian, Latino and White adult diabetes patients treated with insulin or secretagogues (Sulfonylureas or Meglitinides), receiving care from integrated healthcare delivery systems across the United States. We calculated age- and sex-standardized annual SH rates and average annual percent change (AAPC) in SH rates.Annual SH rates ranged from 1.8% to 2.1% during this 7-year observation period (2,200,471 person-years). African Americans had consistently higher SH rates compared with Whites, while Latinos and Asians had consistently lower rates compared with Whites in each of the 7 years (all p0.01). The trend increased significantly only among African Americans (AAPC = +4.3%; 95% CI: +2.1, +6.5%); in the other groups, the AAPC was not significantly different from zero.Surveillance efforts should monitor the racial/ethnic-specific rates. The factors underlying substantially higher rates of hypoglycemia in African Americans should be evaluated. Clinically and culturally-appropriate strategies to reduce the risk of SH need to be developed and tested.
Databáze: OpenAIRE
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