Differences in A1C by race and ethnicity among patients with impaired glucose tolerance in the diabetes prevention program

William H. Herman, Yong Ma, Gabriel Uwaifo, Steven Haffner, Steven E. Kahn, Edward S. Horton, John M. Lachin, Maria G. Montez, Tina Brenneman, Elizabeth Barrett-Connor

Research output: Contribution to journalArticle

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Abstract

OBJECTIVE - We sought to examine racial and ethnic differences in A1C in individuals with impaired glucose tolerance (IGT). RESEARCH DESIGN AND METHODS - We studied 3,819 individuals aged ≥25 years with IGT who were found to be eligible to participant in the Diabetes Prevention Program. A1C was compared among five racial and ethnic groups before and after adjustment for factors that differed among groups or might affect glycemia including age, sex, education, marital status, blood pressure, adiposity (BMI and waist circumference), hematocrit, fasting and post- glucose load glucose levels, glucose area under the curve (AUC), β-cell function, and insulin resistance. RESULTS - Mean ± SD A1C was 5.91 ± 0.50%. Among whites, A1C was 5.80 ± 0.44%, among Hispanics 5.89 ± 0.46%, among Asian 5.96 ± 0.45%, among American Indians 5.96 ± 0.46%, and among blacks 6.19 ± 0.59%. Age, sex, systolic blood pressure, diastolic blood pressure, BMI, fasting glucose, glucose AUC, corrected insulin response, and insulin resistance were each independent predictors of A1C. Adjusting for these and other factors, mean A1C levels were 5.78% for whites, 5.93% for Hispanics, 6.00% for Asians, 6.12% for American Indians, and 6.18% for blacks (P < 0.001). CONCLUSIONS - A1C levels are higher among U.S. racial and ethnic minority groups with IGT after adjustment for factors likely to affect glycemia. Among patients with IGT, A1C may not be valid for assessing and comparing glycemic control across racial and ethnic groups or as an indicator of health care disparities.

Original languageEnglish (US)
Pages (from-to)2453-2457
Number of pages5
JournalDiabetes Care
Volume30
Issue number10
DOIs
StatePublished - Oct 2007

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Glucose Intolerance
Blood Pressure
Glucose
Ethnic Groups
Hispanic Americans
Area Under Curve
Insulin Resistance
Fasting
Healthcare Disparities
Minority Groups
Sex Education
Asian Americans
North American Indians
Adiposity
Marital Status
Waist Circumference
Hematocrit
Research Design
Insulin

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism

Cite this

Herman, W. H., Ma, Y., Uwaifo, G., Haffner, S., Kahn, S. E., Horton, E. S., ... Barrett-Connor, E. (2007). Differences in A1C by race and ethnicity among patients with impaired glucose tolerance in the diabetes prevention program. Diabetes Care, 30(10), 2453-2457. https://doi.org/10.2337/dc06-2003

Differences in A1C by race and ethnicity among patients with impaired glucose tolerance in the diabetes prevention program. / Herman, William H.; Ma, Yong; Uwaifo, Gabriel; Haffner, Steven; Kahn, Steven E.; Horton, Edward S.; Lachin, John M.; Montez, Maria G.; Brenneman, Tina; Barrett-Connor, Elizabeth.

In: Diabetes Care, Vol. 30, No. 10, 10.2007, p. 2453-2457.

Research output: Contribution to journalArticle

Herman, WH, Ma, Y, Uwaifo, G, Haffner, S, Kahn, SE, Horton, ES, Lachin, JM, Montez, MG, Brenneman, T & Barrett-Connor, E 2007, 'Differences in A1C by race and ethnicity among patients with impaired glucose tolerance in the diabetes prevention program', Diabetes Care, vol. 30, no. 10, pp. 2453-2457. https://doi.org/10.2337/dc06-2003
Herman, William H. ; Ma, Yong ; Uwaifo, Gabriel ; Haffner, Steven ; Kahn, Steven E. ; Horton, Edward S. ; Lachin, John M. ; Montez, Maria G. ; Brenneman, Tina ; Barrett-Connor, Elizabeth. / Differences in A1C by race and ethnicity among patients with impaired glucose tolerance in the diabetes prevention program. In: Diabetes Care. 2007 ; Vol. 30, No. 10. pp. 2453-2457.
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abstract = "OBJECTIVE - We sought to examine racial and ethnic differences in A1C in individuals with impaired glucose tolerance (IGT). RESEARCH DESIGN AND METHODS - We studied 3,819 individuals aged ≥25 years with IGT who were found to be eligible to participant in the Diabetes Prevention Program. A1C was compared among five racial and ethnic groups before and after adjustment for factors that differed among groups or might affect glycemia including age, sex, education, marital status, blood pressure, adiposity (BMI and waist circumference), hematocrit, fasting and post- glucose load glucose levels, glucose area under the curve (AUC), β-cell function, and insulin resistance. RESULTS - Mean ± SD A1C was 5.91 ± 0.50{\%}. Among whites, A1C was 5.80 ± 0.44{\%}, among Hispanics 5.89 ± 0.46{\%}, among Asian 5.96 ± 0.45{\%}, among American Indians 5.96 ± 0.46{\%}, and among blacks 6.19 ± 0.59{\%}. Age, sex, systolic blood pressure, diastolic blood pressure, BMI, fasting glucose, glucose AUC, corrected insulin response, and insulin resistance were each independent predictors of A1C. Adjusting for these and other factors, mean A1C levels were 5.78{\%} for whites, 5.93{\%} for Hispanics, 6.00{\%} for Asians, 6.12{\%} for American Indians, and 6.18{\%} for blacks (P < 0.001). CONCLUSIONS - A1C levels are higher among U.S. racial and ethnic minority groups with IGT after adjustment for factors likely to affect glycemia. Among patients with IGT, A1C may not be valid for assessing and comparing glycemic control across racial and ethnic groups or as an indicator of health care disparities.",
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AU - Herman, William H.

AU - Ma, Yong

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AU - Kahn, Steven E.

AU - Horton, Edward S.

AU - Lachin, John M.

AU - Montez, Maria G.

AU - Brenneman, Tina

AU - Barrett-Connor, Elizabeth

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N2 - OBJECTIVE - We sought to examine racial and ethnic differences in A1C in individuals with impaired glucose tolerance (IGT). RESEARCH DESIGN AND METHODS - We studied 3,819 individuals aged ≥25 years with IGT who were found to be eligible to participant in the Diabetes Prevention Program. A1C was compared among five racial and ethnic groups before and after adjustment for factors that differed among groups or might affect glycemia including age, sex, education, marital status, blood pressure, adiposity (BMI and waist circumference), hematocrit, fasting and post- glucose load glucose levels, glucose area under the curve (AUC), β-cell function, and insulin resistance. RESULTS - Mean ± SD A1C was 5.91 ± 0.50%. Among whites, A1C was 5.80 ± 0.44%, among Hispanics 5.89 ± 0.46%, among Asian 5.96 ± 0.45%, among American Indians 5.96 ± 0.46%, and among blacks 6.19 ± 0.59%. Age, sex, systolic blood pressure, diastolic blood pressure, BMI, fasting glucose, glucose AUC, corrected insulin response, and insulin resistance were each independent predictors of A1C. Adjusting for these and other factors, mean A1C levels were 5.78% for whites, 5.93% for Hispanics, 6.00% for Asians, 6.12% for American Indians, and 6.18% for blacks (P < 0.001). CONCLUSIONS - A1C levels are higher among U.S. racial and ethnic minority groups with IGT after adjustment for factors likely to affect glycemia. Among patients with IGT, A1C may not be valid for assessing and comparing glycemic control across racial and ethnic groups or as an indicator of health care disparities.

AB - OBJECTIVE - We sought to examine racial and ethnic differences in A1C in individuals with impaired glucose tolerance (IGT). RESEARCH DESIGN AND METHODS - We studied 3,819 individuals aged ≥25 years with IGT who were found to be eligible to participant in the Diabetes Prevention Program. A1C was compared among five racial and ethnic groups before and after adjustment for factors that differed among groups or might affect glycemia including age, sex, education, marital status, blood pressure, adiposity (BMI and waist circumference), hematocrit, fasting and post- glucose load glucose levels, glucose area under the curve (AUC), β-cell function, and insulin resistance. RESULTS - Mean ± SD A1C was 5.91 ± 0.50%. Among whites, A1C was 5.80 ± 0.44%, among Hispanics 5.89 ± 0.46%, among Asian 5.96 ± 0.45%, among American Indians 5.96 ± 0.46%, and among blacks 6.19 ± 0.59%. Age, sex, systolic blood pressure, diastolic blood pressure, BMI, fasting glucose, glucose AUC, corrected insulin response, and insulin resistance were each independent predictors of A1C. Adjusting for these and other factors, mean A1C levels were 5.78% for whites, 5.93% for Hispanics, 6.00% for Asians, 6.12% for American Indians, and 6.18% for blacks (P < 0.001). CONCLUSIONS - A1C levels are higher among U.S. racial and ethnic minority groups with IGT after adjustment for factors likely to affect glycemia. Among patients with IGT, A1C may not be valid for assessing and comparing glycemic control across racial and ethnic groups or as an indicator of health care disparities.

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