Diabetes Complications Related to Genetic Factors More Than Access to Care, JAMA Study Finds

Differences in long-term diabetes complications result more from varying genetic backgrounds than from access to differing levels of medical care, according to a study published in the May 15 issue of the Journal of the American Medical Association, which is dedicated to diabetes research. The study, conducted by Kaiser Permanente researchers, examined 62,432 people with Type I and Type II diabetes who were members of the Kaiser Permanente Medical Care Program in northern California between 1995 and 1998 (Karter et al., JAMA, 5/15). The researchers determined that African Americans, Asians and Latinos were more likely to experience kidney failure than whites, who were more likely to experience heart attacks. In addition, whites and African-Americans had an equally greater risk than Asians and Latinos of experiencing a stroke or congestive heart failure (Kay, Los Angeles Times, 5/15). Finally, the researchers found that African-Americans, whites and Latinos were 60% more likely than Asians to have a limb amputated because of complications from diabetes (Manning, USA Today, 5/15). Researchers concluded that genetic factors and the "contribution of unmeasured environmental factors" might have led to the difference in complication rates (JAMA, 5/15). The full study is available online.

Policy Response Needed
Although policy makers and insurance companies are "beginning to recognize the seriousness" of diabetes, it is a disease that "requires an integrated, global response," Dr. Christopher Saudek, president of the American Diabetes Association writes in a JAMA editorial. The findings in the current issue of JAMA "highlight the need to address issues of chronic disease in general" and "should be of great interest to the clinician and the policy maker alike" (Saudek, JAMA, 5/15). Saudek spoke at a May 14 briefing during which the JAMA research was presented (USA Today, 5/15). An interview from NPR's "All Things Considered" with JAMA Editor Catherine DeAngelis about the diabetes special issue, including the study about complications, is available online. Note: You must have RealPlayer to hear the interview.