New York — Racial/ethnic disparities in glycemic control among non-Hispanic Black (NHB) and non-Hispanic white (NHW) veterans with Type 2 diabetes (T2D) have persisted, especially with very poor glycemic control, according to a new study.
The study published in Diabetes Care examined trends in early glycemic control by race/ethnicity to understand how disparities soon after T2D diagnosis have changed between 2008 and 2019 among cohorts of U.S. veterans with newly diagnosed T2D.1
For the study led by NYU Grossman School of Medicine and the VA NY Harbor Healthcare System, both in New York, researchers estimated the annual percentage of early glycemic control (average A1C <7%) in the first 5 years after diagnosis among 837,023 veterans (95% male) with newly diagnosed T2D in primary care.
They compared early glycemic control by racial/ethnic group among cohorts defined by diagnosis year (2008-2010, 2011-2013, 2014-2016 and 2017-2018) and estimated odds ratios of early glycemic control comparing racial/ethnic groups with NHW, adjusting for age, sex and years since diagnosis.
Results indicated that the average annual percentage of veterans who achieved early glycemic control during follow-up was 73%, 72%, 72% and 76% across the four cohorts, respectively.
“All racial/ethnic groups were less likely to achieve early glycemic control compared with NHW veterans in the 2008-2010 cohort,” the authors pointed out. “In later cohorts, NHB and Hispanic veterans were more likely to achieve early glycemic control; however, Hispanic veterans were also more likely to have an A1C ≥9% within 5 years in all cohorts. Early glycemic control disparities for non-Hispanic Asian, Native Hawaiian/Pacific Islander, and American Indian/Alaska Native veterans persisted in cohorts until the 2017-2018 cohort.”
The researchers concluded that overall early glycemic control trends among veterans with newly diagnosed T2D have been stable since 2008, but trends differed by racial/ethnic groups and disparities in very poor glycemic control were still present. “Efforts should continue to minimize disparities among racial/ethnic groups,” the authors advised.
- Hua S, Kanchi R, Anthopolos R, Schwartz MD, Pendse J, Titus AR, Thorpe LE. Trends in Racial/Ethnic Disparities in Early Glycemic Control Among Veterans Receiving Care in the Veterans Health Administration, 2008-2019. Diabetes Care. 2024 Sep 10:dc240892. doi: 10.2337/dc24-0892. Epub ahead of print. PMID: 39255441.
