Question: Mexican Americans have high rates of diabetic complications. Does the level of care that Mexican Americans (MA) receive explain these high rates? Study design & population: Prospective cohort of 1200 diabetic patients in 8 indigent care clinics in south Texas, All medical care for 2 years will be abstracted as well as outcomes. Data: chart abstraction and patient surveys. Preliminary data on the first 140 patients for 1 yr will be presented. Results: Demographics: age 56±10, 75%female, diabetes (DM) duration 8.8 yrs±7, average (AV) # of complications 1.9 with 33% having no complications, AV # of comorbidities 4.5±3.9. Health care utilization: 6.8 visits to primary care provider (PCP) per year, 4.6 scheduled, 2.2 unscheduled. Of these, 5.9 are related to DM, 4.4 scheduled and 1.5 unscheduled. 89% had no ER visit and 88% had no hospitalization. For five recommended screenings (eye annually, feet 2x/yr, proteinuria annually, HgA1c 2x/yr, lipids annually), on AV only 2.2 were met. 14% had none of the screenings in the last year and 5% had all five screenings. 84% had not seen a dietician in the last year and 66% had not had any diabetes education in the last year. Outcomes: AV fasting glucose 193±57mg/dl, random glucose 241±79mg/dl, HgAlc 9.2%±2.3. Only 8% had a random (R) and 20% had a fasting (F) glucose <140mg/dl, 26% R & 40% F 140-200, and 65% R & 40% F >200. AV BP sys 138±17, dias 79±9. AV Cholesterol 212±55. No correlation found between total number of comorbid conditions and glycemic control but significant positive correlation found between number of comorbidities and number of PCP visits as well as number of screening items completed. Conclusions: Adequate glycemic control has not been achieved in this group of low income, high comorbid MA patients. Although seen frequently by PCP, few patients had completed recommended screening for complications.
|Original language||English (US)|
|Journal||Journal of Investigative Medicine|
|State||Published - Jan 1 1996|
ASJC Scopus subject areas
- Biochemistry, Genetics and Molecular Biology(all)