Racial and Ethnic Disparities in Glycemic Control Among Patients With SARS-CoV-2 in the Baltimore-Washington, District of Columbia Region.
Racial and Ethnic Disparities in Glycemic Control Among Patients With SARS-CoV-2 in the Baltimore-Washington, District of Columbia Region.
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DOI：
10.1016/j.focus.2023.100156
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发表时间：
2024-02
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影响因子：
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通讯作者：
Page, Kathleen R
中科院分区：
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作者：
Parent, Cassandra;Martinez, Diego A;Venkataramani, Maya;Yang, Cui;Page, Kathleen R
血糖控制不佳在拉丁裔和黑人患者中更为常见。血糖控制不佳的患者与缺乏健康保险和没有初级保健提供者有关。英语水平有限的患者血糖控制更可能较差。拉丁裔未确诊糖尿病的比例最高。糖尿病是 COVID-19 的主要危险因素，对边缘化人群的影响尤为严重。我们分析了巴尔的摩-华盛顿哥伦比亚特区地区 SARS-CoV-2 检测呈阳性的患者血糖控制方面的种族/民族差异。对 2020 年 3 月 1 日至 2022 年 3 月 31 日期间在约翰·霍普金斯医疗系统中 SARS-CoV-2 检测呈阳性的患者中通过 HbA1c 测量的血糖控制情况进行了按种族和民族进行比较。使用逻辑回归确定了与血糖控制不良 (HbA1c≥8) 相关的危险因素。黑人、拉丁裔和亚裔患者的糖尿病前期 (HbA1c=5.7%–6.49%) 和糖尿病 (HbA1c≥6.5%) 比例高于非西班牙裔白人患者。在糖尿病患者中，年轻人（年龄≤44岁）、拉丁裔患者（AOR=1.5；95% CI=1.1, 1.9）、黑人患者（AOR=1.2；95% CI=1.0, 1.5）、未参保患者（AOR=1.5；95% CI=1.2, 1.9）和非参保患者中，血糖控制不良（HbA1c≥8%）的比例显着较高。英语水平有限 (AOR=1.3; 95% CI=1.0, 1.6) 或没有初级保健医生 (AOR=1.6; 95% CI=1.3, 2.1)。 SARS-CoV-2 检测呈阳性的患者血糖控制的差异与潜在的结构性因素有关，例如获得护理、健康保险和语言能力。有必要实施易于使用、适合文化和语言的预防和初级保健计划，让社会经济弱势群体参与糖尿病筛查和护理。
Poor glycemic control was more common among Latino and Black patients. Patients with poor glycemic control were associated with a lack of health insurance and not having a primary care provider. Patients with limited English proficiency were more likely to have poor glycemic control. Latinos had the highest rate of undiagnosed diabetes. Diabetes is a leading risk factor for COVID-19, disproportionally impacting marginalized populations. We analyzed racial/ethnic differences in glycemic control among patients who tested positive for SARS-CoV-2 in the Baltimore–Washington, District of Columbia region. Glycemic control measured by HbA1c was compared by race and ethnicity among patients with a positive SARS-CoV-2 test at the Johns Hopkins Health System between March 1, 2020, and March 31, 2022. Risk factors associated with poor glycemic control (HbA1c≥8) were identified using logistic regression. Black, Latino, and Asian patients had a higher rate of prediabetes (HbA1c=5.7%–6.49%) and diabetes (HbA1c≥6.5%) than non-Hispanic White patients. Among patients with diabetes, poor glycemic control (HbA1c≥8%) was significantly higher among young adults (aged ≤44 years), Latino patients (AOR=1.5; 95% CI=1.1, 1.9), Black patients (AOR=1.2; 95% CI=1.0, 1.5), uninsured patients (AOR=1.5; 95% CI=1.2, 1.9), and those with limited English proficiency (AOR=1.3; 95% CI=1.0, 1.6) or without a primary care physician (AOR=1.6; 95% CI=1.3, 2.1). Disparities in glycemic control among patients who tested positive for SARS-CoV-2 were associated with underlying structural factors such as access to care, health insurance, and language proficiency. There is a need to implement accessible, culturally and language-appropriate preventive and primary care programs to engage socioeconomically disadvantaged populations in diabetic screening and care.