Quality of care for patients with type 2 diabetes in general practice according to patients’ethnic background

	Tweet

In recent decades immigration to Norway from Asia, Africa and Eastern Europe has increased rapidly. The aim of this study was to assess the quality of care for type 2 diabetes mellitus (T2DM) patients from these ethnic minority groups compared with the care received by Norwegians.

Methods: In 2006, electronic medical record data were screened at 11 practices (49 GPs; 58857 patients).

1653 T2DM patients cared for in general practice were identified. Ethnicity was defined as self-reported country of birth.

Chi-squared tests, one-way ANOVAs, multiple regression, linear mixed effect models and generalized linear mixed models were used.

Results: Diabetes was diagnosed at a younger age in patients from the ethnic minority groups (South Asians (SA): mean age 44.9 years, Middle East/North Africa (MENA): 47.2 years, East Asians (EA):52.0 years, others: 49.0 years) compared with Norwegians (59.7 years, p<0.001). HbA1c, systolic blood pressure (SBP) and s-cholesterol were measured in >85% of patients in all groups with minor differences between minority groups and Norwegians.

A greater proportion of the minority groups were prescribed hypoglycaemic medications compared with Norwegians ([greater than or equal to] 79% vs. 72%, p<0.001).

After adjusting for age, gender, diabetes duration, practice and physician unit, HbA1c (geometric mean) for Norwegians was 6.9% compared to 7.3-7.5% in the minority groups (p<0.05). The proportion with poor glycaemic control (HbA1c >9%) was higher in minority groups (SA: 19.6%, MENA: 18.9% vs.

Norwegians: 5.6%, p<0.001. No significant ethnic differences were found in the proportions reaching the combined target: HbA1c [less than or equal to]7.5%, SBP [less than or equal to]140 mmHg, diastolic blood pressure (DBP) [less than or equal to]85mmHg and total s-cholesterol [less than or equal to]5.0 mmol/L (Norwegians: 25.5%, SA: 24.9%, MENA: 26.9%, EA: 26.1%, others:17.5%).

Conclusions: Mean age at the time of diagnosis of T2DM was 8-15 years younger in minority groups compared with Norwegians.

Recording of important processes of care measures is high in all groups. Only one in four of most patient groups achieved all four treatment targets and prescribing habits may be sub-optimal.

Patients from minority groups have worse glycaemic control than Norwegians which implies that it might be necessary to improve the guidelines to meet the needs of specific ethnic groups.

Author: Anh TranLien DiepJohn CooperTor ClaudiJorund StraandKare BirkelandWibeche IngskogAnne Jenum
Credits/Source: BMC Health Services Research 2010, 10:145

BioMedCentral

RELATED STORIES:
Phone contact with nurses linked with better outcomes for women with gestational diabetes   Death rate drops among Americans with diabetes -CDC   Correct treatment of common diabetic foot infections can reduce amputations   “Pre-diabetes,” diabetes rising among U.S. teens   Experimental bariatric surgery controls blood sugar in rats with diabetes   53 millions Americans might develop diabetes by 2025   New inflammation hormone link may pave way to study new drugs for type 2 diabetes   Diabetic retinopathy research could reduce screening costs   Liver fat gets a wake-up call that maintains blood sugar levels   Low testosterone levels could raise diabetes risk for men   Prosthetic lets diabetic get a foot up on life   Dealing with Diabetes, One Patient at a Time

Comments

[ + Post Your Own ]

Now you're in the public comment zone. What follows is not Armenian Medical Network's stuff; it comes from other people and we don't vouch for it. A reminder: By using this Web site you agree to accept our Terms of Service. Click here to read the Rules of Engagement.

There are no comments for this entry yet. [ + Comment here + ]