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Glucose control in diabetes: the impact of racial differences on monitoring and outcomes

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Abstract

Type 2 diabetes is the seventh leading cause of death in the US and is projected to increase in prevalence globally. Minorities are disproportionately affected by diabetes and data suggest that clinical outcomes consistently fall below American Diabetes Association recommendations. The purpose of this systematic review was to examine ethnic differences in self-monitoring and outcomes in adults with type 2 diabetes. Medline was searched for articles published between January 1990 and January 2012 by means of a reproducible strategy. Inclusion criteria included (1) published in English, (2) targeted African Americans, Hispanic, or Asian adults, ages 18+ years with type 2 diabetes, (3) cross-sectional, cohort, or intervention study, and (4) measured change in glycemic control, BP, lipids, or quality of life by race. Twenty-two papers met the inclusion criteria and were reviewed. Overall, significant racial differences and barriers were found in published studies in diabetes management as it pertains to self-monitoring and outcomes. African Americans tend to consistently exhibit worse outcomes and control when compared to other minority populations and non-Hispanic Whites. In conclusion, significant racial differences and barriers exist in diabetes management as it pertains to self-monitoring and outcomes when compared to non-Hispanic Whites. Explanatory and intervention studies are needed to determine the mechanisms and mediators of these differences and strategies to reduce these disparities. In addition, more research is needed to investigate the impact of racial differences in self-monitoring and outcomes on quality of life.

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The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Center for Health Disparities Research, Medical University of South Carolina, 135 Rutledge Avenue, Room 280G, PO Box 250593, Charleston, SC, 29425, USA

    Jennifer A. Campbell, Rebekah J. Walker, Brittany L. Smalls & Leonard E. Egede

  2. Division of General Internal Medicine and Geriatrics, Department of Medicine, Medical University of South Carolina, Charleston, SC, USA

    Leonard E. Egede

  3. Center for Disease Prevention and Health Interventions for Diverse Populations, Charleston VA REAP, Ralph H. Johnson VA Medical Center, Charleston, SC, USA

    Rebekah J. Walker & Leonard E. Egede

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  1. Jennifer A. Campbell
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  2. Rebekah J. Walker
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  3. Brittany L. Smalls
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  4. Leonard E. Egede
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Correspondence to Leonard E. Egede.

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Campbell, J.A., Walker, R.J., Smalls, B.L. et al. Glucose control in diabetes: the impact of racial differences on monitoring and outcomes. Endocrine 42, 471–482 (2012). https://doi.org/10.1007/s12020-012-9744-6

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  • DOI: https://doi.org/10.1007/s12020-012-9744-6

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