Racial and Ethnic Disparities in Glycemic Control Among Insured US Adults
Authors' conclusion
In this cross-sectional study of insured adults with diabetes in the US, disparities in poor glycemic control persisted despite adjustment for social, health care, and behavioral factors. Research is needed to identify the barriers contributing to poor control even in populations with access to care.
Study context
- Population
- Insured US adults aged 25 to 80 years with self-reported diabetes, NHANES 2003 to 2018representing 16,337,362 US adults
- Participants
- 4,070 adults
- Exposure
- Hispanic or Latino and non-Hispanic Black vs non-Hispanic White adults
- Hispanic or Latinon = 1,146
- Non-Hispanic Blackn = 1,196
- Non-Hispanic Whiten = 1,728reference
- Outcome
- Poor glycemic control: Hemoglobin A1c (HbA1c) of 7.0% or greater
Methodological detailsData analyzed from January 15 to August 23, 2023
- Data analyzed from January 15 to August 23, 2023
Main finding
As reported in the abstract
Poor glycemic control (HbA1c ≥7.0%)
Each group vs Non-Hispanic WhiteOdds ratio (95% CI)
Hispanic or Latino
1.46(1.16–1.83)
Non-Hispanic Black
1.28(1.04–1.57)
Observational data: associations, not effects.
Further findings
Poor glycemic control after further adjustment for social factors (especially food security)
- Hispanic or Latino: OR
- 1.39; 95% CI, 1.08-1.81
- Black: OR
- 1.39; 95% CI, 1.08-1.81
- Some attenuation
Poor glycemic control after accounting for health care and behavioral or health status factors
- Hispanic or Latino individuals: OR
- 1.63; 95% CI, 1.24-2.16
- Racial and ethnic disparities among those with private insurance: OR
- 1.66; 95% CI, 1.10-2.52
- Disparities increased
Original publication
Racial and Ethnic Disparities in Glycemic Control Among Insured US Adults. JAMA Netw Open. Published 2 October 2023. doi:10.
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