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OBJECTIVE - To evaluate ethnic differences in medication concerns (e.g., side effects and costs) that may contribute to ethnic differences in the adoption of and adherence to type 2 diabetes treatments.
RESEARCH DESIGN AND METHODS - We conducted face-to-face interviews from May 2004 to May 2006 with type 2 diabetic patients ≥18 years of age (N = 676; 25% Latino, 34% non-Hispanic Caucasian, and 41% non-Hispanic African American) attending Chicago-area clinics. Primary outcomes of interest were concerns regarding medications and willingness to take additional medications.
RESULTS - Latinos and African Americans had higher A1C levels than Caucasians (7.69 and 7.54% vs. 7.18%, respectively; P < 0.01). Latinos and African Americans were more likely than Caucasians to worry about drug side effects (66 and 49% vs. 39%, respectively) and medication dependency (65 and 52% vs. 39%, respectively; both P < 0.01). Ethnic minorities were also more likely to report reluctance to adding medications to their regimen (Latino 12%, African American 18%, and Caucasian 7%; P < 0.01). In analyses adjusted for demographics, income, education, and diabetes duration, current report of pain/discomfort with pills (odds ratio 2.43 [95% CI 1.39-4.27]), concern regarding disruption of daily routine (1.97 [1.14-3.42]), and African American ethnicity (2.48 [1.32-4.69]) emerged as major predictors of expressed reluctance to adding medications.
CONCLUSIONS - Latinos and African Americans had significantly more concerns regarding the quality-of-life effects of diabetes-related medications than Caucasians. Whether these medication concerns contribute significantly to differences in treatment adoption and disparities in care deserves further exploration.
Diabetes Care 32:311-316, 2009
Type 2 diabetic patients of racial/ ethnic minorities experience signifi- cantly higher rates of diabetes- related complications than non-Hispanic Caucasians. In population-based studies, non-Hispanic African Americans have rates of renal disease, blindness, amputa- tions, and amputation-related mortality two to four times greater than those of Caucasians (1-3). Similarly, Latinos have higher rates of renal disease and retinopathy than Caucasians (1,2,4,5). African American patients have age-adjusted diabetes mortality rates that are approximately twice those of Caucasians (6). The elimination of such health disparities is a major goal of the U.S. preventive health agenda (7).
Efforts to reduce the burden of diabetes complications have focused on improving the delivery of comprehensive diabetes care while simultaneously addressing control of blood glucose, blood pressure, and...