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Native Americans, Alaskans More Likely to Have Higher HbA1c Levels

by U.S. Medicine

March 31, 2015

OAKLAND, CA – American Indians and Alaska Natives (AI/AN) are more than twice as likely to have diabetes as non-Hispanic Caucasians, and the prevalence of diabetes in the AI/AN populations has increased by more than 68% since 1994.

A study group led by researchers from Kaiser Permanente Northern California sought to compare cardiovascular disease risk factor testing rates and intermediate outcomes of care between AI/AN patients with diabetes and non-Hispanic Caucasians enrolled in nine commercial integrated delivery systems in the United States. The results of the study were published recently in the journal BMJ Open Diabetes Research & Care.1

For the study, researchers compared annual testing rates and risk factor control levels for glycated hemoglobin (HbA1c), low-density lipoprotein cholesterol (LDL-C) and systolic blood pressure (SBP). They also looked at the number of unique diabetes drug classes, insulin use and oral diabetes drug medication adherence between insured AI/AN and non-Hispanic white adults with diabetes older than 18 in 2011.

With 5,831 AI/AN patients — 1.8% of the cohort — meeting inclusion criteria, results indicated that AI/AN patients had similar rates of annual HbA1c, LDL-C and SBP testing, as well as LDL-C and SBP control, compared with non-Hispanic Caucasians. AI/AN patients were significantly more likely to have HbA1c greater than 9%, however, and significantly less likely to adhere to their oral diabetes medications compared to the other group.

“AI/AN patients in commercial integrated delivery systems have similar blood pressure and cholesterol testing and control, but significantly lower rates of HbA1c control and diabetes medication adherence, compared with non-Hispanic Caucasians,” the authors conclude. “As more AI/ANs move to urban and suburban settings, clinicians and health plans should focus on addressing disparities in diabetes care and outcomes in this population.”

  1. 1 Schmittdiel JA, Steiner JF, Adams AS, Dyer W, et al. Diabetes care and outcomes for American Indians and Alaska natives in commercial integrated delivery systems: a SUrveillance, PREvention, and ManagEment of Diabetes Mellitus (SUPREME-DM) Study. BMJ Open Diabetes Res Care. 2014 Nov 17;2(1):e000043. doi: 10.1136/bmjdrc-2014-000043. eCollection 2014.PubMed PMID: 25452877; PubMed Central PMCID: PMC4246918.

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