Comparison of laboratory test frequency and test results between African-Americans and Caucasians with diabetes: opportunity for improvement. Findings from a large urban health maintenance organization

• Published in: Diabetes care Vol. 20; no. 6; pp. 971 - 977
• Main Authors: Wisdom, Kimberlydawn, Fryzek, Jon P, Havstad, Suzanne L, Anderson, Robert M, Dreiling, Michael C, Tilley, Barbara C
• Format: Journal Article
• Language: English
• Published: Alexandria, VA American Diabetes Association 01.06.1997
• Subjects: African Americans; Biological and medical sciences; Blood Chemical Analysis - statistics & numerical data; Cholesterol - blood; Creatinine - blood; Cross-Sectional Studies; Diabetes Mellitus, Type 1 - blood; Diabetes Mellitus, Type 1 - therapy; Diabetes Mellitus, Type 2 - blood; Diabetes Mellitus, Type 2 - therapy; Diabetes. Impaired glucose tolerance; Endocrine pancreas. Apud cells (diseases); Endocrinopathies; European Continental Ancestry Group; Female; Glycated Hemoglobin A - analysis; Health Maintenance Organizations - standards; Humans; Male; Management. Various non-drug treatments. Langerhans islet grafts; Medical Records Systems, Computerized; Medical sciences; Middle Aged; Midwestern United States; Socioeconomic Factors; Urban Population; Endocrinopathy; Creatinine; Human; Cholesterolemia; Diabetes mellitus; Hemoglobin A1; Statistical study; Recommendation; Result; Surveillance; Biomedical information; Laboratory investigations; Clinical biology; Race; Frequency; Comparative study; Public health
• ISSN: 0149-5992; 1935-5548
• DOI: 10.2337/diacare.20.6.971

Comparison of laboratory test frequency and test results between African-Americans and Caucasians with diabetes: opportunity for improvement. Findings from a large urban health maintenance organization. K Wisdom , J P Fryzek , S L Havstad , R M Anderson , M C Dreiling and B C Tilley Henry Ford Health System, Henry Ford Health Sciences Center, Center for Medical Treatment Effectiveness Programs, Detroit, MI 48202, USA. kwisdom1@biostat.hfh.edu Abstract OBJECTIVE: To compare African-American and Caucasian patients with preexisting diabetes in a health maintenance organization (HMO) on: 1) frequency with which they received a subset of recommended laboratory tests according to the American Diabetes Association (ADA) consensus guidelines and 2) the results of laboratory test values (glycosylated hemoglobin, cholesterol, and creatinine). RESEARCH DESIGN AND METHODS: A cross-sectional study of 2,312 HMO members with diabetes continuously enrolled during 1991 was conducted using computerized medical record and billing data. Receipt of the ADA recommended tests for glycosylated hemoglobin, cholesterol, and creatinine was compared between African-Americans and Caucasians, stratified by insulin requirements. In addition, group comparisons were made based on the laboratory test results. RESULTS: Less than 20 percent of all subjects received the recommended number of ADA tests. This did not differ by race except for creatinine and cholesterol testing in insulin users only, where African-Americans had more tests. On average, after adjusting for covariates, African-Americans had significantly higher glycosylated hemoglobin and creatinine laboratory values. Both groups had elevated cholesterol values. CONCLUSIONS: The opportunity exists to improve the process of care for both African-Americans and Caucasians with diabetes in an HMO setting. The need to improve glycosylated hemoglobin results and subsequently limit complications is especially pressing among the African-American population.