Self-Management Skills and Racial/Ethnic Disparities in Diabetes Outcomes

Objective: Racial and ethnic minorities experience higher rates of Type 2 diabetes (T2DM) and higher HbA1c levels (HbA1c) than non-minorities. Limited data exist to examine relationship(s) between HbA1c and the complex array of self-management behaviors in persons with T2DM including underserved/minority populations. The purpose of this study was to identify factors that may be associated with racial/ethnic disparities in HbA1c for adults with T2DM.

Methods: Three hundred ambulatory patients with T2DM, from a healthcare organization in central Texas, participated in a RCT diabetes self-management study. The patient's baseline HbA1c was obtained from EMR and only patients with an HbA1c ≥ 7.5% were included. Baseline data included demographics such as race/ethnicity, age, gender, education and income; as well as HR-QOL, nutrition physical activity, and foot care. Quantitative methods were used to evaluate differences in outcomes by race/ethnicity.

Results: Patients (n=300) provided consent and participated in the study. Baseline HbA1c levels were significantly (p<0.05) higher for Blacks (10.01) and Hispanics (9.85), than for whites (9.10). However, no significant differences were found by race/ethnicity for self-management skills measures, including foot care, nutrition, blood sugar testing. While not statistically significant, covariates were consistent with anticipated HbA1c trends given adherence to diabetes self-management protocols.

Conclusions: These results imply that self-management skills may reduce health disparities when used in targeted populations. Promoting diabetes self-management protocols may decrease HbA1c blood levels. Self-management interventions may provide potential opportunities for interventions to reduce health disparities when used in targeted populations.