Indigent diabetics distrust medical system

A survey of people with diabetes attending a clinic for the indigent found that they have little trust in the medical system, and that attitude is remarkably consistent for all the respondents.

"We were surprised to find that trust in the medical care system did not differ significantly by race or ethnicity," Dr. Leonard E. Egede told Reuters Health. "This suggests that mistrust may not be an important contributor to observed ethnic disparities in diabetes outcomes."

Egede and Dr. Yvonne Michel of the Medical University of South Carolina, Charleston studied 216 middle-aged and older adults. As reported in the medical journal Diabetes Care, 40 percent of the subjects were white and the remainder black. The aim was to establish whether race played a part in attitudes to medical care, and whether attitudes reflected how well diabetes was controlled.

As well as finding no correlation between race and medical mistrust, Egede said, "we were also surprised that trust in the medical care system was not correlated with measures of metabolic control."

However, he added, "more trusting patients felt more in control of their diabetes and reported better physical and mental health."

The researchers note that they did not collect information on factors such as patient-provider communication that might affect an individual's trust in the medical system, and they intend to look into this in future studies.

Diabetes Care, January 2006.