Diabetes Control Poorer among Blacks than Whites

By Megan Rauscher

NEW YORK (Reuters Health) – African American adults with diabetes have higher hemoglobin A1C levels — an indicator of poor blood sugar control — than their non-Hispanic white counterparts, a review of published studies found.

The lower level of blood sugar control seen in African Americans "may contribute to disparity in diabetes morbidity and mortality in this population," Dr. Julienne K. Kirk and colleagues note in a report in Diabetes Care.

The research team evaluated data from 11 studies reporting A1C levels for 42,273 whites and 14,670 blacks with diabetes. Most of these individuals were older than 50 years of age. The goal level for A1C is less than 7 percent.

The combined data show an estimated 0.65 percent difference between groups in hemoglobin A1C, "indicating a higher A1C across studies for African Americans," the team reports.

"The range of A1C values across the 11 studies was 7.3 percent to 9.4 percent for whites and 7.6 percent to 11.4 percent for blacks," Kirk, from Wake Forest University in Winston-Salem, North Carolina, told Reuters Health.

"The higher A1C in blacks compared to whites may contribute to diabetes complications," Kirk said, noting that in the UK Prospective Diabetes Study there was a 21 percent reduction in diabetes complications for every 1 percent reduction in A1C.

Therefore, the difference noted in the current review represents an approximate 15 percent reduction in the risk of complications among non-Hispanic whites.

"More effort needs to be focused upon getting patients to A1C goal," Kirk concluded, and she encourages doctors and patients to "spend time discussing goals for diabetes control with patients."

"We need to understand more fully why this disparity exists and to eliminate factors that may be changeable, such as improving access to care," she said.

SOURCE: Diabetes Care online August 25, 2006.