Racial/Ethnic Disparities in Management of Diabetes

描述（由申请人提供）：糖尿病（DM）是美国发病率和死亡率的主要原因。据估计，美国目前有1820万人患有DM（500万人未确诊），反映出在过去二十年中大约增加了100%。发病率正在上升，发生在年轻人身上，糖尿病的负担最重的是少数成年人。据估计，2000年出生于美国的人患糖尿病的终生风险现在是三分之一。尽管成功开发了新的治疗方案，但糖尿病管理的进展一直难以捉摸;只有7.3%的糖尿病诊断患者达到血糖，血压和胆固醇的治疗目标，自1988年以来几乎没有改善。推动这项研究的概念模型预测，个人的易感性，使和需要的特点将解释差异的管理DM。这项研究的主要目的是更好地了解促进或阻碍有效管理DM的因素，并根据需要，促进开发文化多样性的材料/战略，以解决不同少数群体DM管理的具体方面。来自三个独立的BRFSS调查（2001年，2002年和2003年）的数据将被用来测试从模型得出的假设。非西班牙裔白人、非西班牙裔非洲裔美国人和18岁及以上的西班牙裔DM患者将是研究的重点。关键因变量包括15项糖尿病临床和自我管理指标。OLS多元回归和Logistic回归是基本的分析策略。分析计划将由16名本科生（和数量有限的研究生）在为期一个学期的4学分的讲座/实验室课程中实施，由研究人员授课，并由博士级研究助理协助。结果将通过糖尿病研究日在当地传播，并通过同行评议的期刊文章在全国范围内传播。AREA（R15）是支持拟议研究的理想机制。

DESCRIPTION (provided by applicant): Diabetes mellitus (DM) is a major cause of morbidity and mortality in the U.S. An estimated 18.2 million people in the U.S. now have DM (5 million are undiagnosed), reflecting an approximate 100% increase over the past two decades. The incidence is escalating, occurs at younger ages, and the burdens of DM fall most heavily on minority adults. Estimates of the lifetime risk of developing DM among people bom in the U.S. in 2000 are now one-in-three. Despite the successful development of new treatment regimens, progress in the management of DM has been elusive; only 7.3% of people diagnosed with DM meet treatment goals for blood glucose, blood pressure and cholesterol, and there has been little improvement since 1988. The conceptual model that drives this research study predicts that individual predisposing, enabling and need characteristics will explain disparities in the management of DM. The main objective of the study is to gain a better understanding of factors that facilitate or impede effective management of DM and, as needed, contribute to development of culturally-diverse materials/strategies for addressing specific aspects of management of DM in different minority groups. Data from three separate BRFSS surveys (2001, 2002 and 2003) will be used to test hypotheses derived from the model. Non-Hispanic Whites, non- Hispanic African Americans and Hispanics 18 years of age and older with DM will be the focus of the research. Key dependent variables include 15 indicators of clinical and self-management of DM. OLS multiple regression and logistic regression are the basic analytic strategies. The analytic plan will be implemented by 16 undergraduate (and a limited number of graduate) students during a semester-long, 4 credit-hour lecture/lab course taught by the investigators, with the assistance of a doctoral-level research assistant. Results will be disseminated locally via a Diabetes Research Day and nationally through peer- reviewed journal articles. The AREA (R15) is an ideal mechanism to support the proposed research.