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Disparities/Minority Health

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Black, Hispanic, and white patients with diabetes differ in performance of self-care behaviors to manage their disease

Blacks and Hispanics are more likely to suffer from diabetes than whites. They are also more likely to suffer from diabetes-related complications such as kidney and eye disease and limb amputations (due to poor circulation and wound healing). Diabetes self-management tasks such as exercise, proper diet, and foot care can improve control of blood sugar (glycemic) levels and reduce complications and deaths from diabetes. Yet few people with diabetes engage in multiple diabetes self-care behaviors at the recommended levels. There are also significant racial/ethnic differences in the performance of these self-care behaviors, according to a new study.

Researchers assessed four diabetes self-care behaviors: physical activity, fruit and vegetable consumption, glucose (HbA1c) testing, and foot examination, among 21,459 ethnically diverse patients with diabetes who participated in the 2003 Behavioral Risk Factor Surveillance Survey.

About 90 percent of patients performed at least one self-care behavior. However, only 6 percent of patients studied engaged in all four self-care behaviors, a number that ranged from 5 percent in noninsulin users to 8 percent in insulin users. Blacks were 37 percent less likely to exercise than whites. Hispanics and patients from other races (others) were not significantly different from whites. Hispanics were 36 percent less likely and others 31 percent less likely to do home glucose testing, while blacks were not significantly different from whites.

Blacks were 42 percent more likely to do home foot examinations, while Hispanics and others were not significantly different from whites. Blacks were 44 percent less likely to engage in all four behaviors, while Hispanics and others were not significantly different from whites. There were no significant racial/ethnic differences in fruit and vegetable consumption. Interventions tailored to the diverse needs of diabetics from different ethnic groups are needed, such as addressing barriers to physical activity in blacks.

The study was supported in part by the Agency for Healthcare Research and Quality (HS11418).

See "Racial/ethnic differences in multiple self-care behaviors in adults with diabetes," by Chiagozie Nwasuruba, M.D., Mokbul Khan, Ph.D., and Leonard E. Egede, M.D., M.S., in the January 2007 Journal of General Internal Medicine 22, pp. 115-120.

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