TY - JOUR
T1 - Differences in the Use and Quality of Antidiabetic Therapies in Mexican American and Non-Hispanic Whites With Uncontrolled Type 2 Diabetes in the US
T2 - NHANES 2003-2012
AU - Perez, Alexandra
AU - Elrod, Shara
AU - Sanchez, Jesus
N1 - Funding Information:
This study was funded by an internal grant from the Nova Southeastern University Health Professions Division. The funding source had no role in the design, conduct, or analysis of the study or the decision to submit the manuscript for publication.
PY - 2015/10
Y1 - 2015/10
N2 - Purpose The purpose of this study was to determine the use of clinical guideline–recommended antidiabetic therapies among Mexican Americans (MA) and non-Hispanic whites with uncontrolled type 2 diabetes. A secondary data analysis based on the National Health and Nutrition Examination Survey (NHANES) 2003-2012 cohort data including MA and non-Hispanic white adults with uncontrolled (A1C ≥6.5%) type 2 diabetes. There was no difference in the use of recommended regimens across race/ethnic group (MA, 63.6% vs whites, 65.7%); however, MA were less likely to have regimens intensified to non-insulin triple therapies (7.3% vs 11.3%) or insulin-based therapies (23.7% vs 30.5%) and were more likely to be on no medications (17.2% vs 10.4%). Mexican Americans and whites who were most uncontrolled were least likely to be on recommended regimens (A1C 6.5%-7.4%, 83.0%; A1C 7.5%-9%, 60.6%; and A1C >9%, 50.4%). This pattern was most pronounced among MA compared to whites. Use of recommended therapies decreased 50.5 percentage points for MA and 20.1 percentage points among whites from an A1C level of 6.5% to 7.4% to >9%, respectively. The quality of antidiabetic therapies of MA and whites with type 2 diabetes who are most uncontrolled need improvement. Intensifying pharmacotherapies among MA may help improve glycemic control disparities. The innovative outcome used in this report may be useful in quality of care studies in the future.
AB - Purpose The purpose of this study was to determine the use of clinical guideline–recommended antidiabetic therapies among Mexican Americans (MA) and non-Hispanic whites with uncontrolled type 2 diabetes. A secondary data analysis based on the National Health and Nutrition Examination Survey (NHANES) 2003-2012 cohort data including MA and non-Hispanic white adults with uncontrolled (A1C ≥6.5%) type 2 diabetes. There was no difference in the use of recommended regimens across race/ethnic group (MA, 63.6% vs whites, 65.7%); however, MA were less likely to have regimens intensified to non-insulin triple therapies (7.3% vs 11.3%) or insulin-based therapies (23.7% vs 30.5%) and were more likely to be on no medications (17.2% vs 10.4%). Mexican Americans and whites who were most uncontrolled were least likely to be on recommended regimens (A1C 6.5%-7.4%, 83.0%; A1C 7.5%-9%, 60.6%; and A1C >9%, 50.4%). This pattern was most pronounced among MA compared to whites. Use of recommended therapies decreased 50.5 percentage points for MA and 20.1 percentage points among whites from an A1C level of 6.5% to 7.4% to >9%, respectively. The quality of antidiabetic therapies of MA and whites with type 2 diabetes who are most uncontrolled need improvement. Intensifying pharmacotherapies among MA may help improve glycemic control disparities. The innovative outcome used in this report may be useful in quality of care studies in the future.
UR - http://www.scopus.com/inward/record.url?scp=84942111784&partnerID=8YFLogxK
U2 - 10.1177/0145721715593813
DO - 10.1177/0145721715593813
M3 - Article
C2 - 26175481
AN - SCOPUS:84942111784
VL - 41
SP - 582
EP - 591
JO - The Diabetes Educator
JF - The Diabetes Educator
SN - 0145-7217
IS - 5
ER -