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Regional Variation in Diabetic Outcomes by Country-of-Origin and Language in an Urban Safety Net Hospital

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Abstract

Adherence to diabetic care guidelines among US immigrants remains low. This study assesses adherence to diabetic care guidelines by country-of-origin and language among a limited English-proficient (LEP) population. Timely completion of diabetic measures and acceptable levels of hemoglobin A1c (A1c), low density lipoprotein (LDL) cholesterol, and blood pressure (BP) were compared between LEP and English-proficient (EP) patients in this 2013 retrospective cohort study of adult diabetics. More LEP patients met BP targets (83 vs. 68 %, p < 0.0001) and obtained LDL targets (89 vs. 85 %, p = 0.0007); however, they had worse LDL control (57 vs. 62 %, p = 0.0011). Ethiopians and Somalians [adjusted OR (95 % CI) = 0.44 (0.30, 0.63)] were less likely than Latin Americans to meet BP goals. LEP patients outperformed EP peers on several diabetic outcomes measures with important variation between groups. These data highlight the success of a safety net hospital in improving diabetes management among diverse populations.

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Acknowledgments

This study was funded by the Robert D. and Patricia E. Kern Mayo Clinic Center for the Science of Health Care Delivery.

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Authors and Affiliations

  1. United Family Medicine Residency Program, Saint Paul, MN, USA

    April K. Wilhelm

  2. Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, MN, USA

    Debra J. Jacobson & Chun Fan

  3. Minneapolis Medical Research Foundation, 701 Park Avenue South (P7), Minneapolis, MN, 55415, USA

    Laura Guzman-Corrales & Deborah H. Boehm

  4. Analytic Center of Excellence, Hennepin County Medical Center, Minneapolis, MN, USA

    Karen Baker

  5. Division of Primary Care Internal Medicine, Mayo Clinic, Rochester, MN, USA

    Jane W. Njeru & Mark L. Wieland

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  1. April K. Wilhelm
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  2. Debra J. Jacobson
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  5. Karen Baker
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Correspondence to Laura Guzman-Corrales.

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Wilhelm, A.K., Jacobson, D.J., Guzman-Corrales, L. et al. Regional Variation in Diabetic Outcomes by Country-of-Origin and Language in an Urban Safety Net Hospital. J Community Health 41, 798–804 (2016). https://doi.org/10.1007/s10900-016-0155-0

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  • DOI: https://doi.org/10.1007/s10900-016-0155-0

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