Income, Race Are Factors Influencing Whether Diabetics Properly Manage Condition, Study Finds

Black and Hispanic adults with diabetes, as well as those with lower incomes, are less likely than whites or those with higher incomes to monitor their blood glucose levels, according to a study presented at the American Heart Association's Annual Conference on Cardiovascular Disease Epidemiology and Prevention, HealthDay/Washington Post reports. "Minority and financially vulnerable adults with insulin-treated diabetes appear to have lower reported rates of self-monitoring of blood glucose [SMBG] -- a vital disease management component," Deborah Levine, an assistant professor in general medicine at the Ohio State University College of Medicine, said.

For the study, Levine and colleagues examined daily self-monitoring blood glucose rates in 16,630 Hispanic, black and white adults with insulin-treated diabetes.

Researchers found that among participants with annual household incomes of at least $20,000, SMBG rates were 78% for Hispanics, 77% for blacks and 85% for whites. Among those with annual incomes less than $20,000, SMBG rates were 65% for Hispanics, 79% for blacks and 85% for whites. In addition, 49% of Hispanics with annual incomes less than $20,000 received diabetes education, compared with 64% of blacks and 62% of whites, the study found. Diabetes education did not vary by race or ethnicity for participants with annual incomes over $20,000.

Levine said, "At incomes of $20,000 or more, both Hispanics and blacks had 40% lower odds of daily SMBG compared to whites. At incomes of less than $20,000, however, the odds of daily SMBG decreased by 70% for Hispanics compared to whites but did not change for blacks." Overall, fewer blacks and Hispanics at every income level properly monitored their SMBG levels than whites.

Levine said the findings indicate that income should be "explicitly considered when assessing SMBG performance and designing SMBG interventions for Hispanics with insulin-treated diabetes." She said that "given that Hispanics and blacks have a higher frequency of diabetes-related complications compared to whites," more collection and evaluation of SMBG data among Hispanics and blacks is needed. She added, "We need to better understand income's role in racial and ethnic disparities in SMBG to offer effective programs and policies to improve SMBG by minorities" (HealthDay/Washington Post, 3/14).