Ethnic and social disparity in glycaemic control in type 2 diabetes; cohort study in general practice 2004–9

Authors
Gareth D James, Peter Baker, Ellena Badrick, Rohini Mathur, Sally Hull, John Robson
Year
2012
Journal
Journal of the Royal Society of Medicine, , -
DOI
10.1258/jrsm.2012.110289
Abstract

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
3
Model data structure
Response types
Multivariate response model?
No
Longitudinal data?
Yes
Substantive discipline
Paper submitted by
James Gareth, Primary Care & Population Health, University College London, g.james@ucl.ac.uk
Edit this page