Ethnic and social disparity in glycaemic control in type 2 diabetes; cohort study in general practice 2004–9
- Journal of the Royal Society of Medicine, , -
Objective: To determine whether ethnic group differences in glycated haemoglobin (HbA1c) changed over a 5-year period in people on medication for type 2 diabetes.
Design: Open cohort in 2004–9.
Setting: Electronic records of 100 of the 101 general practices in two inner London boroughs.
Participants: People aged 35 to 74 years on medication for type 2 diabetes.
Main outcome measures: Mean HbA1c and proportion with HbA1c controlled to ≤7.5%.
Results: In this cohort of 24,111 people, 22% were White, 58% South Asian and 17% Black African/Caribbean. From 2004 to 2009 mean HbA1c improved from 8.2% to 7.8% for White, from 8.5% to 8.0% for Black African/Caribbean and from 8.5% to 8.0% for South Asian people. The proportion with HbA1c controlled to 7.5% or less, increased from 44% to 56% in White, 38% to 53% in Black African/Caribbean and 34% to 48% in South Asian people. Ethnic group and social deprivation were independently associated with HbA1c. South Asian and Black African/Caribbean people were treated more intensively than White people.
Conclusion: HbA1c control improved for all ethnic groups between 2004–9. However, South Asian and Black African/Caribbean people had persistently worse control despite more intensive treatment and significantly more improvement than White people. Higher social deprivation was independently associated with worse control.
- Number of levels
- Model data structure
- Response types
- Multivariate response model?
- Longitudinal data?
- Substantive discipline
- Paper submitted by
- James Gareth, Primary Care & Population Health, University College London, firstname.lastname@example.org