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Research ArticleOriginal Research

Heterogeneity in Management of Diabetes Mellitus Among Latino Ethnic Subgroups in the United States

Arch G. Mainous, Vanessa A. Diaz, Sonia Saxena and Mark E. Geesey
The Journal of the American Board of Family Medicine November 2007, 20 (6) 598-605; DOI: https://doi.org/10.3122/jabfm.2007.06.070115
Arch G. Mainous III
PhD
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Vanessa A. Diaz
MD, MS
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Sonia Saxena
MD
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Mark E. Geesey
MS
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Article Figures & Data

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    Table 1.

    United States Population Estimates, Sample Number, and Percentages (Standard Error) of Various Demographic and Access to Care Characteristics for Each Ethnic Population*

    Non-Latino WhiteNon-Latino BlackMexicanPuerto RicanOther LatinoAll Races χ2PLatinos Only χ2P
    United States population estimate9,790,9592,124,369963,740282,473310,046
    Unweighted sample (n)1,3454182276086
    Acculturation (% [SE])
        Interview conducted in English99.8%100.0%57.2%66.4%49.5%<.001.221
    (0.11)(0.0)(3.61)(6.28)(7.30)
        Born in United States95.7%92.7%49.0%31.3%25.1%<.001.002
    (0.66)(1.70)(3.64)(7.25)(7.16)
        US citizen98.4%97.5%65.4%100.0%75.56%<.001<.001
    (0.47)(0.77)(3.39)(0.00)(5.25)
        ≥15 years in US (if not US born)71.6%82.9%77.5%82.5%82.2%.757.770
    (8.19)(5.60)(5.26)(6.34)(5.00)
    Social demographics (% [SE])
        Age (≥45 years)87.4 (1.15)81.2 (2.24)74.0 (3.06)80.3 (5.95)86.4 (4.23).001.074
        Male51.0 (1.64)43.7 (2.91)51.0 (3.79)50.2 (6.76)47.0 (5.91).305.853
        Annual family income ≥$20,00076.1 (1.29)58.9 (3.10)60.4 (3.65)60.3 (6.68)46.7 (7.12)<.001.227
        Education: high school grad or less (no college)52.9 (1.54)63.2 (3.10)73.1 (3.91)76.9 (6.45)66.0 (7.32)<.001.533
        BMI ≥ 3051.7 (1.61)58.1 (2.77)47.5 (3.83)50.5 (6.31)48.3 (6.78).194.923
    Access to health care (% [SE])
        Have health insurance93.8 (0.84)92.1 (1.31)74.0% (3.15)83.2 (6.16)84.3 (4.53)<.001.117
        Have usual place for care when sick97.2 (0.56)96.7 (1.04)90.9 (2.31)87.7 (5.29)91.3 (4.06).034.851
        Never had to delay care90.8 (0.87)89.9 (1.64)82.4 (2.55)92.0 (3.46)94.7 (2.36).012.005
        Among people who had delayed care, lack of money was not a reason57.2 (5.09)47.3 (9.27)43.1 (7.16)48.3† (21.6)84.7 (14.4).279.223
        Had a physicians office visit during past year96.8 (0.65)96.8 (0.92)93.4 (1.87)94.2 (2.91)92.4 (3.40).398.914
        No overnight hospital stays during past year76.0 (1.46)72.8 (2.51)87.3 (2.37)80.8 (4.54)77.7 (5.64).003.167
    • * χ2 P values are calculated across all ethnic groups and among Latino groups only (Mexicans, Puerto Ricans, and Other Latinos).

    • † Estimate should be used with caution because there are fewer than 30 people in the cell and thus it does not meet the standard of reliability or precision.

    • BMI, body mass index; SE, standard error.

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    Table 2.

    Various Diabetes Management Issues for Each Ethnic Population*

    Non-Latino WhiteNon-Latino BlackMexicanPuerto RicanOther LatinoAll Races χ2PLatinos Only χ2P
    Seeing one doctor for diabetes care84.6 (1.17)85.4 (1.88)77.4 (3.15)89.5 (4.27)73.0 (5.12).042.046
    Seen a nurse/dietician in past year42.1 (1.57)51.9 (2.92)49.4 (4.42)49.1 (7.20)36.1 (6.17).018.228
    Does not check blood glucose at least 1 time per day63.9 (2.05)69.7 (3.89)67.0 (5.85)69.6 (8.45)85.30 (7.72).181.198
    Checks feet for sores 1 or more times per week76.9 (1.33)78.2 (2.30)74.8 (3.18)68.0 (8.24)78.19 (4.98).740.555
    Has not heard of HbA1c58.7 (1.70)65.5 (2.75)75.8 (3.70)63.6 (6.84)76.5 (5.34)<.001.289
    Doctor checked feet for ulcers during past year68.8 (1.42)80.4 (2.14)68.5 (3.28)77.3 (5.95)63.1 (5.12)<.001.229
    Had exam for retinopathy during past year65.5 (1.52)70.8 (2.97)54.7 (4.02)67.2 (6.61)67.9 (6.63).028.089
    Had cholesterol check during past year81.7 (1.20)79.2 (2.39)72.8 (3.74)66.7 (8.34)78.0 (5.26).089.510
    Had blood pressure check during past year94.2 (0.87)92.8 (1.42)85.3 (2.46)91.7 (3.80)90.8 (3.44).034.203
    • * Data shown as % (standard error). χ2 P values are calculated across all ethnic groups and among Latino groups only (Mexicans, Puerto Ricans, and Other Latinos).

    • HbA1c, glycosylated hemoglobin.

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    Table 3.

    Unadjusted Logistic Regression Models Calculating the Relative Likelihood of a Latino Having One Doctor for Diabetes Care, Knowing About Glycosylated Hemoglobin, or Having Had an Exam for Retinopathy Within the Previous Year

    Has Only One DoctorKnows About HbA1cRetinopathy Examination
    Latino group
        Mexican0.40 (0.15 to 1.08)0.56 (0.28 to 1.12)0.59 (0.30 to 1.15)
        Puerto Rican1.01.01.0
        Other0.32 (0.11 to 0.89)0.54 (0.25 to 1.17)1.03 (0.44 to 2.39)
    College education
        No1.01.01.0
        Yes1.17 (0.89 to 1.56)2.38 (1.93 to 2.93)1.42 (1.13 to 1.79)
    Health insurance
        No1.01.01.0
        Yes2.70 (1.82 to 3.99)1.77 (1.13 to 2.76)3.40 (2.31 to 5.01)
    Usual place for care
        No1.01.01.0
        Yes11.26 (6.12 to 20.73)1.18 (0.63 to 2.19)3.09 (1.68 to 5.66)
    Interview language
        English1.01.01.0
        Spanish0.51 (0.33 to 0.80)0.36 (0.24 to 0.54)0.63 (0.44 to 0.91)
    • Data shown as odds ratio (95% confidence interval).

    • HbA1c, glycosylated hemoglobin.

    • View popup
    Table 4.

    Adjusted Logistic Regression Models Calculating the Relative Likelihood of a Latino Having Only One Doctor for Diabetes Care, Knowing About Glycosylated Hemoglobin, or Having had an Exam for Retinopathy Within the Previous Year

    Has Only One Doctor for Diabetes CareKnows About HbA1cRetinopathy Examination
    Latino group
        Mexican0.24 (0.07 to 0.85)0.39 (0.18 to 0.84)0.77 (0.35 to 1.67)
        Puerto Rican1.01.01.0
        Other0.15 (0.04 to 0.58)0.50 (0.21 to 1.19)1.07 (0.42 to 2.70)
    College education
        No1.01.01.0
        Yes1.19 (0.47 to 3.02)2.68 (1.35 to 5.34)0.76 (0.37 to 1.54)
    Health insurance
        No1.01.01.0
        Yes1.40 (0.50 to 3.95)1.65 (0.75 to 3.66)2.12 (1.10 to 4.10)
    Usual place for care
        No1.01.01.0
        Yes8.88 (2.73 to 28.89)1.09 (0.28 to 4.21)1.12 (0.44 to 2.83)
    Interview language
        English1.01.01.0
        Spanish0.51 (0.23 to 1.13)1.01 (0.43 to 2.35)0.41 (0.19 to 0.88)
    • All models were also adjusted for sex, age, family income, and immigrant status, which were not significant predictors in the full models. Data shown as odds ratio (95% confidence interval). HbA1c, glycosylated hemoglobin.

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The Journal of the American Board of Family Medicine: 20 (6)
The Journal of the American Board of Family Medicine
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November-December 2007
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Heterogeneity in Management of Diabetes Mellitus Among Latino Ethnic Subgroups in the United States
Arch G. Mainous, Vanessa A. Diaz, Sonia Saxena, Mark E. Geesey
The Journal of the American Board of Family Medicine Nov 2007, 20 (6) 598-605; DOI: 10.3122/jabfm.2007.06.070115

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Heterogeneity in Management of Diabetes Mellitus Among Latino Ethnic Subgroups in the United States
Arch G. Mainous, Vanessa A. Diaz, Sonia Saxena, Mark E. Geesey
The Journal of the American Board of Family Medicine Nov 2007, 20 (6) 598-605; DOI: 10.3122/jabfm.2007.06.070115
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