scholarly journals Racial and Ethnic Disparities in Comorbidities in Youth With Type 2 Diabetes in the Pediatric Diabetes Consortium (PDC)

2021 ◽  
Author(s):  
Fida Bacha ◽  
Peiyao Cheng ◽  
Robin L. Gal ◽  
Lindsey C. Beaulieu ◽  
Craig Kollman ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Ethnic Disparities ◽  
The United States ◽  
Self Report ◽  
Alcoholic Fatty Liver ◽  
Pediatric Diabetes ◽  
Significant Difference ◽  
Racial Ethnic ◽  
Hispanic White

<p><b>Background: </b>Type 2 diabetes in the United States is more prevalent in youth of minority racial-ethnic background but disparities in health outcomes have not be examined in this population. </p> <p><b>Methods: </b>We examined racial-ethnic differences in the initial presentation and subsequent comorbidities in youth with type 2 diabetes (N=1217, 63% females) enrolled in the Pediatric Diabetes Consortium (PDC) Registry from February 2012 to June 2018. Demographic and clinical data were collected from medical records and participant self-report. </p> <p><b>Results: </b>Overall, the mean age at presentation was 13.4 ± 2.4 years, BMI was 35.0 (9.4) kg/m<sup>2</sup>. HbA1c was higher and C-peptide was lower in Non-Hispanic Black (NHB) and Hispanic (H) youth compared to Non-Hispanic White (NHW) youth. NHB were 3 times as likely to present in DKA (19%) vs. NHW (6.3%) and H (7.5%) and both NHB and H had a worse HbA1c trajectory compared with NHW peers. Microalbuminuria was documented in 11%, hypertension in 34% and dyslipidemia in 42% of Registry participants with no significant difference among racial-ethnic groups. Non-alcoholic fatty liver disease (NAFLD) was diagnosed in 9% and 11% of H and NHW, respectively vs. 2% in NHB.</p> <p><b>Conclusion: </b>NHB and H youth with type 2 diabetes presented with worse metabolic control and had persistently worse HbA1c trajectories compared with NHW. Comorbidities exist in a large percentage of these youth independent of race-ethnicity, except for NAFLD being less prevalent in NHB. Greater efforts are needed to mitigate racial-ethnic disparities at diagnosis and in the management of youth with type 2 diabetes. </p>

scholarly journals Racial and Ethnic Disparities in Comorbidities in Youth With Type 2 Diabetes in the Pediatric Diabetes Consortium (PDC)

2021 ◽  
Author(s):  
Fida Bacha ◽  
Peiyao Cheng ◽  
Robin L. Gal ◽  
Lindsey C. Beaulieu ◽  
Craig Kollman ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Ethnic Disparities ◽  
The United States ◽  
Self Report ◽  
Alcoholic Fatty Liver ◽  
Pediatric Diabetes ◽  
Significant Difference ◽  
Racial Ethnic ◽  
Hispanic White

<p><b>Background: </b>Type 2 diabetes in the United States is more prevalent in youth of minority racial-ethnic background but disparities in health outcomes have not be examined in this population. </p> <p><b>Methods: </b>We examined racial-ethnic differences in the initial presentation and subsequent comorbidities in youth with type 2 diabetes (N=1217, 63% females) enrolled in the Pediatric Diabetes Consortium (PDC) Registry from February 2012 to June 2018. Demographic and clinical data were collected from medical records and participant self-report. </p> <p><b>Results: </b>Overall, the mean age at presentation was 13.4 ± 2.4 years, BMI was 35.0 (9.4) kg/m<sup>2</sup>. HbA1c was higher and C-peptide was lower in Non-Hispanic Black (NHB) and Hispanic (H) youth compared to Non-Hispanic White (NHW) youth. NHB were 3 times as likely to present in DKA (19%) vs. NHW (6.3%) and H (7.5%) and both NHB and H had a worse HbA1c trajectory compared with NHW peers. Microalbuminuria was documented in 11%, hypertension in 34% and dyslipidemia in 42% of Registry participants with no significant difference among racial-ethnic groups. Non-alcoholic fatty liver disease (NAFLD) was diagnosed in 9% and 11% of H and NHW, respectively vs. 2% in NHB.</p> <p><b>Conclusion: </b>NHB and H youth with type 2 diabetes presented with worse metabolic control and had persistently worse HbA1c trajectories compared with NHW. Comorbidities exist in a large percentage of these youth independent of race-ethnicity, except for NAFLD being less prevalent in NHB. Greater efforts are needed to mitigate racial-ethnic disparities at diagnosis and in the management of youth with type 2 diabetes. </p>

scholarly journals Relative Contributions of Socioeconomic, Local Environmental, Psychosocial, Lifestyle/Behavioral, Biophysiological, and Ancestral Factors to Racial/Ethnic Disparities in Type 2 Diabetes

Diabetes Care ◽  
2016 ◽  
Vol 39 (7) ◽  
pp. 1208-1217 ◽  
Author(s):  
Rebecca S. Piccolo ◽  
S.V. Subramanian ◽  
Neil Pearce ◽  
Jose C. Florez ◽  
John B. McKinlay
Keyword(s):  
Type 2 Diabetes ◽  
Ethnic Disparities ◽  
Racial Ethnic

A Comparison of the Use of Antidepressant Treatment Between Non-Hispanic Black and White and Mexican American Adults With Type 2 Diabetes in the United States

2017 ◽  
Vol 43 (2) ◽  
pp. 171-179 ◽  
Author(s):  
Alexandra Perez ◽  
Pierina Cabrera ◽  
Carolina Gutierrez ◽  
Jose Valdes
Keyword(s):  
Type 2 Diabetes ◽  
Depressive Symptoms ◽  
Depressive Symptom ◽  
Ethnic Group ◽  
Antidepressant Treatment ◽  
The United States ◽  
Symptom Level ◽  
Antidepressant Use ◽  
Racial Ethnic

Purpose The purpose of this study was to determine antidepressant use among Mexican Americans (MA) and non-Hispanic (NH) blacks and whites with type 2 diabetes and depressive symptoms. Methods A secondary data analysis based on National Health and Nutrition Examination Survey (NHANES) 2005-2012 cohort data included 560 noninstitutionalized civilian MA, NH black, and NH white adults with type 2 diabetes and depressive symptoms. Unadjusted and adjusted 2-way ANOVA models evaluated whether there was a difference in the use of antidepressants by depressive symptom level across race/ethnic group. Results Whites were more likely than blacks and MA to be on antidepressant treatment (whites: 41.7%, blacks: 27.1%, MA: 24.2%) and on serotonin-norepinephrine reuptake inhibitors (SNRI) (whites: 8.1%, blacks: 2.9%, MA: 2.4%). However, there was no difference in the use of other drug classes or antidepressant use by depressive symptom level across racial/ethnic group. Followed by tricyclic antidepressants (TCA), selective serotonin reuptake inhibitors (SSRI) were the most commonly used drug class overall. Approximately 30% of subjects were on antidepressants and among those, 80% were on one antidepressant, all others on 2 or more. Conclusions Racial/ethnic differences were observed in the use of antidepressant treatment but not when depressive symptom levels were incorporated in the analyses. Further studies on the effectiveness of different antidepressants in diabetes outcomes minorities are needed.

Does receiving care in a medical home reduce racial/ethnic disparities in ED visits among children with asthma in the United States?

2016 ◽  
Vol 21 (1) ◽  
pp. 25-35 ◽  
Author(s):  
Susan X Lin ◽  
Richard G Younge ◽  
Lawrence C Kleinman
Keyword(s):  
Medical Home ◽  
Ethnic Disparities ◽  
Prevalence Ratio ◽  
The United States ◽  
Care Quality ◽  
Latino Children ◽  
Care Needs ◽  
Children With Asthma ◽  
Racial Ethnic ◽  
Hispanic White

Evidence has shown the implementation of medical home model improves care quality and outcomes. However, it is not clear whether receiving care from a medical home has any impact on racial/ethnic disparities in emergency department (ED) use by children with asthma. This study using the US National Survey of Children with Special Health Care Needs, 2009–2010, estimated racial/ethnic disparities in ED use. Generalized liner models were used to examine factors associated with ED use. Racial/ethnic differences in ED use were attenuated after adjusting for socio-economic variables. Ratios of prevalence ratios were calculated to examine the effect modification of medical home on ED use associated with race/ethnicity. The adjusted prevalence ratio of ED use of the Black to non-Hispanic White was 1.51 (95% confidence interval (CI): 1.36–1.67) with medical home and 1.35 (95% CI: 1.24–1.47) without medical home. Among those with care from a medical home Latino children had higher ED use compared with White children. There is no evidence that the self-reported care from a medical home narrows the gaps in ED use between non-Hispanic White and Black or Latino children with asthma.

scholarly journals Racial and Ethnic Disparities in Heart and Cerebrovascular Disease Deaths During the COVID-19 Pandemic in the United States

Circulation ◽  
2021 ◽  
Author(s):  
Rishi Wadhera ◽  
Jose F. Figueroa ◽  
Fatima Rodriguez ◽  
Michael Liu ◽  
Wei Tian ◽  
...  
Keyword(s):  
United States ◽  
Heart Disease ◽  
Cerebrovascular Disease ◽  
Ethnic Minorities ◽  
Minority Group ◽  
Ethnic Disparities ◽  
The United States ◽  
Race Ethnicity ◽  
Racial Ethnic ◽  
Hispanic White

Background: Cardiovascular deaths increased during the early phase of the COVID-19 pandemic in the United States. However, it is unclear whether racial/ethnic minorities have experienced a disproportionate rise in heart disease and cerebrovascular disease deaths. Methods: We used the National Center for Health Statistics to identify heart disease and cerebrovascular disease deaths for non-Hispanic White, non-Hispanic Black, non-Hispanic Asian, and Hispanic individuals from March-August 2020 (pandemic period), as well as for the corresponding months in 2019 (historical control). We determined the age- and sex-standardized deaths per million by race/ethnicity for each year. We then fit a modified Poisson model with robust standard errors to compare change in deaths by race/ethnicity for each condition in 2020 vs. 2019. Results: There were a total of 339,076 heart disease and 76,767 cerebrovascular disease deaths from March through August 2020, compared to 321,218 and 72,190 deaths during the same months in 2019. Heart disease deaths increased during the pandemic in 2020, compared with the corresponding period in 2019, for non-Hispanic White (age-sex standardized deaths per million, 1234.2 vs. 1208.7; risk ratio for death [RR] 1.02, 95% CI 1.02-1.03), non-Hispanic Black (1783.7 vs. 1503.8; RR 1.19, 1.17-1.20), non-Hispanic Asian (685.7 vs. 577.4; RR 1.19, 1.15-1.22), and Hispanic (968.5 vs. 820.4, RR 1.18, 1.16-1.20) populations. Cerebrovascular disease deaths also increased for non-Hispanic White (268.7 vs. 258.2; RR 1.04, 95% CI 1.03-1.05), non-Hispanic Black (430.7 vs. 379.7; RR 1.13, 95% CI 1.10-1.17), non-Hispanic Asian (236.5 vs. 207.4; RR 1.15, 1.09-1.21), and Hispanic (264.4 vs. 235.9; RR 1.12, 1.08-1.16) populations. For both heart disease and cerebrovascular disease deaths, each racial and ethnic minority group experienced a larger relative increase in deaths than the non-Hispanic White population (interaction term, p<0.001). Conclusions: During the COVID-19 pandemic in the US, Black, Hispanic, and Asian populations experienced a disproportionate rise in deaths due to heart disease and cerebrovascular disease, suggesting that racial/ethnic minorities have been most impacted by the indirect effects of the pandemic. Public health and policy strategies are needed to mitigate the short- and long-term adverse effects of the pandemic on the cardiovascular health of minority populations.

scholarly journals Endocrine and Metabolic Comorbidities in Hospitalized Psoriasis Patients in the United States

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A11-A12
Author(s):  
Ehizogie Edigin ◽  
Precious Eseaton ◽  
Hafeez Shaka ◽  
Emmanuel Akuna ◽  
Iriagbonse Asemota ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
United States ◽  
Type 2 Diabetes ◽  
Metabolic Syndrome ◽  
Type 2 Diabetes Mellitus ◽  
Fatty Liver Disease ◽  
The United States ◽  
Alcoholic Fatty Liver ◽  
Alcoholic Fatty Liver Disease

Abstract Introduction: Psoriasis is a chronic immune-mediated, genetic disease manifesting in the skin or joints or both. Studies have shown an association between psoriasis and metabolic syndrome [1]. However, there is a scarcity of studies on metabolic and endocrine co-morbidities of hospitalized psoriasis patients. This study aims to compare the prevalence of metabolic and endocrine co-morbidities in hospitalized psoriasis patients to hospitalized non-psoriasis patients. Methods: Data were abstracted from the National Inpatient Sample (NIS) 2016 and 2017 Database. NIS is the largest inpatient hospitalization database in the United States. The NIS was searched for hospitalizations for adult patients aged 18 years or above with a principal or secondary diagnosis of psoriasis and those without any diagnosis of psoriasis. Chi-square test was used to compare the prevalence of common metabolic and endocrine comorbidities between psoriasis and non-psoriasis hospitalized patients. Co-morbidities were obtained from secondary diagnoses. We used ICD-10 codes to obtain psoriasis hospitalizations and co-morbidities. STATA, version 16 was used for analysis. Results: There were over 71 million discharges in the combined 2016 and 2017 NIS database. Out of this, 323,405 hospitalizations had a diagnosis of psoriasis. Psoriasis hospitalizations had a higher prevalence of dyslipidemia (41.8% vs 31.8%, p&lt;0.0001), hypothyroidism (15.6% vs 12.0%, p&lt;0.0001), hyperthyroidism (0.6% vs 0.5%, p=0.0133), type 2 diabetes mellitus (31.1% vs 24.5%, p&lt;0.0001), obesity (24.4% vs 14.3%, p&lt;0.0001), Non-alcoholic fatty liver disease (0.9% vs 0.3%, p&lt;0.0001) and similar prevalence of type 1 diabetes mellitus (0.9% vs 0.9%, p=0.1567) compared to non-psoriasis hospitalizations. Conclusion: Hospitalized psoriasis patients have a higher prevalence of dyslipidemia, hypothyroidism, hyperthyroidism, type 2 diabetes mellitus, obesity and non-alcoholic fatty liver disease compared to non-psoriasis hospitalized patients. Endocrinology consultation during hospitalization will be helpful in managing these comorbidities in psoriasis patients. References 1. Gisondi P, Fostini AC, Fossà I, Girolomoni G, Targher G. Psoriasis and the metabolic syndrome. Clin Dermatol. 2018;36(1):21–28. doi:10.1016/j.clindermatol.2017.09.005

scholarly journals Health Insurance Is Associated with Decreased Odds for Undiagnosed Prediabetes and Type 2 Diabetes in American Adults

2020 ◽  
Vol 17 (13) ◽  
pp. 4706
Author(s):  
Sean Mahoney ◽  
Adam Bradley ◽  
Logan Pitts ◽  
Stephanie Waletzko ◽  
Sheria G. Robinson-Lane ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Health Insurance ◽  
Private Insurance ◽  
Insurance Coverage ◽  
Logistic Models ◽  
The United States ◽  
Self Report ◽  
Undiagnosed Diabetes ◽  
Diabetes Status

Over a third of adults in the United States have prediabetes, and many of those with prediabetes will progress to type 2 diabetes within 3–5 years. Health insurance status may factor into a proper diagnosis of prediabetes and diabetes. This study sought to determine the associations between health insurance and undiagnosed prediabetes and diabetes in a national sample of American adults. Publicly available data from 13,029 adults aged 18–64 years from the 2005–2016 waves of the National Health and Nutrition Examination Survey were analyzed. Health insurance type (Medicaid, Private, Other, None) was self-reported. Prediabetes and diabetes status were assessed with measures of self-report, glycohemoglobin, fasting plasma glucose, and two-hour glucose. Covariate-adjusted logistic models were used for the analyses. Overall, 5976 (45.8%) participants had undiagnosed prediabetes, while 897 (6.8%) had undiagnosed diabetes. Having health insurance was associated with decreased odds ratios for undiagnosed prediabetes: 0.87 (95% confidence interval (CI: 0.79, 0.95)) for private insurance, 0.84 (CI: 0.73, 0.95) for other insurance, and 0.78 (CI: 0.67, 0.90) for Medicaid. Moreover, having private health insurance was associated with 0.82 (CI: 0.67, 0.99) decreased odds for undiagnosed diabetes. Health insurance coverage and screening opportunities for uninsured individuals may reduce prediabetes and diabetes misclassifications.

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