Regional, geographic, and racial/ethnic variation in glycemic control in a national sample of veterans with diabetes.


OBJECTIVE:We performed a retrospective analysis of a national cohort of veterans with diabetes to better understand regional, geographic, and racial/ethnic variation in diabetes control as measured by HbA(1c). RESEARCH DESIGN AND METHODS:A retrospective cohort study was conducted in a national cohort of 690,968 veterans with diabetes receiving prescriptions for insulin or oral hypoglycemic agents in 2002 that were followed over a 5-year period. The main outcome measures were HbA(1c) levels (as continuous and dichotomized at ≥8.0%). RESULTS:Relative to non-Hispanic whites (NHWs), HbA(1c) levels remained 0.25% higher in non-Hispanic blacks (NHBs), 0.31% higher in Hispanics, and 0.14% higher in individuals with other/unknown/missing racial/ethnic group after controlling for demographics, type of medication used, medication adherence, and comorbidities. Small but statistically significant geographic differences were also noted with HbA(1c) being lowest in the South and highest in the Mid-Atlantic. Rural/urban location of residence was not associated with HbA(1c) levels. For the dichotomous outcome poor control, results were similar with race/ethnic group being strongly associated with poor control (i.e., odds ratios of 1.33 [95% CI 1.31-1.35] and 1.57 [1.54-1.61] for NHBs and Hispanics vs. NHWs, respectively), geographic region being weakly associated with poor control, and rural/urban residence being negligibly associated with poor control. CONCLUSIONS:In a national longitudinal cohort of veterans with diabetes, we found racial/ethnic disparities in HbA(1c) levels and HbA(1c) control; however, these disparities were largely, but not completely, explained by adjustment for demographic characteristics, medication adherence, type of medication used to treat diabetes, and comorbidities.


Diabetes Care


Diabetes care


Egede LE,Gebregziabher M,Hunt KJ,Axon RN,Echols C,Gilbert GE,Mauldin PD




Has Abstract


2011-04-01 00:00:00














  • Comparison of glargine insulin versus rosiglitazone addition in poorly controlled type 2 diabetic patients on metformin plus sulfonylurea.

    abstract:OBJECTIVE:We sought to examine the mechanisms by which the addition of glargine insulin or rosiglitazone improves glycemic control in type 2 diabetic subjects poorly controlled on maximally effective doses of metformin plus sulfonylurea. RESEARCH DESIGN AND METHODS:Subjects (aged 47 +/- 11 years, BMI 31 +/- 5 kg/m(2),...

    journal_title:Diabetes care

    pub_type: 临床试验,杂志文章


    authors: Triplitt C,Glass L,Miyazaki Y,Wajcberg E,Gastaldelli A,De Filippis E,Cersosimo E,DeFronzo RA

    更新日期:2006-11-01 00:00:00

  • Independent Observational Analysis of Ulcer Outcomes for SINBAD and University of Texas Ulcer Scoring Systems.

    abstract:OBJECTIVE:The aim of this study was to compare the University of Texas (UT) and Site, Ischemia, Neuropathy, Bacterial Infection, and Depth (SINBAD) foot ulcer scores in predicting ulcer outcome within a routine diabetes foot clinic. RESEARCH DESIGN AND METHODS:From 2006 to 2018, data were collected from all patients a...

    journal_title:Diabetes care

    pub_type: 杂志文章


    authors: Leese GP,Soto-Pedre E,Schofield C

    更新日期:2021-02-01 00:00:00

  • Development of stable film test for rapid estimation of blood or plasma 3-hydroxybutyrate.

    abstract::A film test for the rapid detection of plasma/serum 3-hydroxybutyrate (3-OHB) has been developed. The film contains NAD, nitro blue tetrazolium, 3-OHB dehydrogenase, and diaphorase, and the surface is coated with modified biomembrane and can detect 50-1500 microM 3-OHB within 2-3 min. One drop or 50 microliters of pla...

    journal_title:Diabetes care

    pub_type: 杂志文章


    authors: Harano Y,Aoki T,Nakajima Y,Kojima H,Kosugi K,Harano A,Hidaka H,Yamada S,Uno S,Shigeta Y

    更新日期:1990-05-01 00:00:00

  • Skeletal muscle deoxygenation after the onset of moderate exercise suggests slowed microvascular blood flow kinetics in type 2 diabetes.

    abstract:OBJECTIVE:People with type 2 diabetes have impaired exercise responses even in the absence of cardiovascular complications. One key factor associated with the exercise intolerance is abnormally slowed oxygen uptake (VO2) kinetics during submaximal exercise. The mechanisms of this delayed adaptation during exercise are ...

    journal_title:Diabetes care

    pub_type: 杂志文章


    authors: Bauer TA,Reusch JE,Levi M,Regensteiner JG

    更新日期:2007-11-01 00:00:00

  • Alcohol and the NIDDM patient.

    abstract::Historically, alcohol use by the diabetic patient has been controversial. Recent studies in the general population have shown an improvement in mortality with moderate alcohol intake (one to three drinks per day). This improved mortality is greatest in those individuals who have a higher risk of ischemic heart disease...

    journal_title:Diabetes care

    pub_type: 杂志文章,评审


    authors: Bell DS

    更新日期:1996-05-01 00:00:00

  • Hemodynamic effects of fenofibrate and coenzyme Q10 in type 2 diabetic subjects with left ventricular diastolic dysfunction.

    abstract:OBJECTIVE:To investigate the effects of fenofibrate and coenzyme Q(10) (CoQ) on diastolic function, ambulatory blood pressure (ABP), and heart rate (HR) in type 2 diabetic subjects with left ventricular diastolic dysfunction (LVDD). RESEARCH DESIGN AND METHODS:We randomized, double-blind, 74 subjects to fenofibrate 16...

    journal_title:Diabetes care

    pub_type: 杂志文章,随机对照试验


    authors: Chew GT,Watts GF,Davis TM,Stuckey BG,Beilin LJ,Thompson PL,Burke V,Currie PJ

    更新日期:2008-08-01 00:00:00

  • Impact of oral antihyperglycemic therapy on all-cause mortality among patients with diabetes in the Veterans Health Administration.

    abstract:OBJECTIVE:The objective of this analysis was to evaluate the impact of several classes of oral antihyperglycemic therapy relative to sulfonylurea monotherapy on all-cause mortality among a cohort of patients with diabetes from the Veterans Health Administration (VHA). RESEARCH DESIGN AND METHODS:A retrospective cohort...

    journal_title:Diabetes care

    pub_type: 杂志文章


    authors: Kahler KH,Rajan M,Rhoads GG,Safford MM,Demissie K,Lu SE,Pogach LM

    更新日期:2007-07-01 00:00:00

  • Night Shift Work, Genetic Risk, and Type 2 Diabetes in the UK Biobank.

    abstract:OBJECTIVE:To examine the effects of past and current night shift work and genetic type 2 diabetes vulnerability on type 2 diabetes odds. RESEARCH DESIGN AND METHODS:In the UK Biobank, we examined associations of current (N = 272,214) and lifetime (N = 70,480) night shift work exposure with type 2 diabetes risk (6,770 ...

    journal_title:Diabetes care

    pub_type: 杂志文章


    authors: Vetter C,Dashti HS,Lane JM,Anderson SG,Schernhammer ES,Rutter MK,Saxena R,Scheer FAJL

    更新日期:2018-04-01 00:00:00

  • Defining Abdominal Obesity as a Risk Factor for Coronary Heart Disease in the U.S.: Results From the Hispanic Community Health Study/Study of Latinos (HCHS/SOL).

    abstract:OBJECTIVE:Various organizations have highlighted the need to examine whether abdominal obesity cut points are appropriate for identification of cardiovascular risk among ethnic minority adults, particularly Hispanic/Latino adults living in Western societies. This study aimed 1) to establish optimal definitions for abdo...

    journal_title:Diabetes care

    pub_type: 杂志文章


    authors: Chirinos DA,Llabre MM,Goldberg R,Gellman M,Mendez A,Cai J,Sotres-Alvarez D,Daviglus M,Gallo LC,Schneiderman N

    更新日期:2020-08-01 00:00:00

  • Glycosylated hemoglobin in relation to rapid fluctuations in blood glucose in children with insulin-dependent diabetes: a comparison of methods with and without prior dialysis.

    abstract::To evaluate the importance of dialysis in the determination of glycosylated hemoglobin (HbA1), we studied blood glucose and HbA1 in 38 insulin-dependent diabetic children during a morning fast and again 6 h postprandially. We used two methods to determine glycosylated hemoglobin: (1) the conventional macrocolumn metho...

    journal_title:Diabetes care

    pub_type: 杂志文章


    authors: Ditzel J,Kjaergaard JJ,Kawahara R,Ostergaard GZ,Mourits-Andersen T

    更新日期:1981-09-01 00:00:00

  • Development of a prediction equation for insulin sensitivity from anthropometry and fasting insulin in prepubertal and early pubertal children.

    abstract:OBJECTIVE:To test the utility of homeostasis model assessment (HOMA) in predicting insulin sensitivity [x10(- 4) min(-1)/(microIU/ml)] in children and to develop and compare two new prediction equations for insulin sensitivity in children using demographic and anthropometric measures in the presence or absence of fasti...

    journal_title:Diabetes care

    pub_type: 杂志文章


    authors: Huang TT,Johnson MS,Goran MI

    更新日期:2002-07-01 00:00:00

  • Blood or urine glucose-based insulin therapy and control of glycemia. Computer-simulation study.

    abstract::Adjustment algorithms for conventional insulin therapy must be tested for safety and efficacy before clinical implementation. We did this by computer simulation. Accordingly, a computer simulator of human intermediary metabolism created 10 randomly chosen diabetic subjects for study. All were well defined with respect...

    journal_title:Diabetes care

    pub_type: 杂志文章


    authors: Albisser AM,Sozzi S,Strack TR

    更新日期:1990-04-01 00:00:00

  • The evaluation of a pocket computer as an aid to insulin dose determination by patients.

    abstract::A small and inexpensive computer was programmed to assist patients in making decisions regarding insulin delivery using constant subcutaneous infusion systems. Insulin dosage was based on gender, pre- and postprandial blood glucose, between-meal blood glucose, patient weight, time of day, and when appropriate, the car...

    journal_title:Diabetes care

    pub_type: 杂志文章


    authors: Chanoch LH,Jovanovic L,Peterson CM

    更新日期:1985-03-01 00:00:00

  • The Impact of Liraglutide on Diabetes-Related Foot Ulceration and Associated Complications in Patients With Type 2 Diabetes at High Risk for Cardiovascular Events: Results From the LEADER Trial.

    abstract:OBJECTIVE:Diabetes-related foot ulcers (DFUs) and their sequelae result in large patient and societal burdens. Long-term data determining the efficacy of individual glucose-lowering agents on DFUs are lacking. Using existing data from the Liraglutide Effect and Action in Diabetes: Evaluation of Cardiovascular Outcome R...

    journal_title:Diabetes care

    pub_type: 杂志文章,多中心研究,随机对照试验


    authors: Dhatariya K,Bain SC,Buse JB,Simpson R,Tarnow L,Kaltoft MS,Stellfeld M,Tornøe K,Pratley RE,LEADER Publication Committee on behalf of the LEADER Trial Investigators.

    更新日期:2018-10-01 00:00:00

  • The development and utility of a novel scale that quantifies the glycemic progression toward type 1 diabetes over 6 months.

    abstract:OBJECTIVE:We developed a scale to serve as a potential end point for 6-month glycemic progression (PS6M) toward type 1 diabetes (T1D) in autoantibody-positive relatives of individuals with T1D. RESEARCH DESIGN AND METHODS:The PS6M was developed from Diabetes Prevention Trial-Type 1 (DPT-1) data and tested in the Trial...

    journal_title:Diabetes care

    pub_type: 杂志文章


    authors: Sosenko JM,Skyler JS,Beam CA,Boulware D,Mahon JL,Krischer JP,Greenbaum CJ,Rafkin LE,Matheson D,Herold KC,Palmer JP,Type 1 Diabetes TrialNet and Diabetes Prevention Trial–Type 1 Study Groups.

    更新日期:2015-05-01 00:00:00

  • Reduction in carotid intima-media thickness after pancreatic islet transplantation in patients with type 1 diabetes.

    abstract:OBJECTIVE:Determine the impact of islet transplantation on carotid intima-media thickness (CIMT), a marker for atherosclerosis, in type 1 diabetes without kidney disease. RESEARCH DESIGN AND METHODS:Consecutive case series of 15 adults (mean age [SD], 49 years [10 years]; 87% female) with type 1 diabetes for ≥5 years ...

    journal_title:Diabetes care

    pub_type: 杂志文章


    authors: Danielson KK,Hatipoglu B,Kinzer K,Kaplan B,Martellotto J,Qi M,Mele A,Benedetti E,Oberholzer J

    更新日期:2013-02-01 00:00:00

  • High incidence of childhood-onset IDDM in Kuwait. Kuwait Study Group of Diabetes in Childhood.

    abstract:OBJECTIVE:To determine the incidence of insulin-dependent diabetes mellitus (IDDM) in children aged 0-14 years in Kuwait, as part of the World Health Organization Multinational Collaborative Study (DIAMOND), and to determine if the incidence rates have increased. RESEARCH DESIGN AND METHODS:All cases of IDDM diagnosed...

    journal_title:Diabetes care

    pub_type: 杂志文章


    authors: Shaltout AA,Qabazard MA,Abdella NA,LaPorte RE,al Arouj M,Ben Nekhi A,Moussa MA,al Khawari MA

    更新日期:1995-07-01 00:00:00

  • The impact of diabetes on survival among patients with first myocardial infarction.

    abstract:OBJECTIVE:The purpose of this paper is to estimate the impact of diabetes on survival among patients with first acute myocardial infarction, using data from the World Health Organization (WHO) Monitoring Trends and Determinants of Cardiovascular Disease (MONICA) Project in Newcastle, New South Wales, Australia. RESEAR...

    journal_title:Diabetes care

    pub_type: 杂志文章


    authors: Chun BY,Dobson AJ,Heller RF

    更新日期:1997-05-01 00:00:00

  • Transient state of NIDDM in a patient with AIDS.

    abstract:OBJECTIVE:To describe a glucose abnormality in AIDS that is characterized by transient NIDDM followed by hyperinsulinemic normoglycemia. RESEARCH DESIGN AND METHODS:A 36-yr-old Hispanic man with AIDS was on long-standing aerosolized pentamidine therapy in 1986. He received a course of intravenous pentamidine 5 mo befo...

    journal_title:Diabetes care

    pub_type: 杂志文章


    authors: Abourizk NN,Lyons RW,Madden GM

    更新日期:1993-06-01 00:00:00

  • Long-term follow-up of oral glucose tolerance test-derived glucose tolerance and insulin secretion and insulin sensitivity indexes in subjects with glucokinase mutations (MODY2).

    abstract:OBJECTIVE:We investigated the natural history of glucokinase (GCK)-related maturity-onset diabetes of the young type 2 (MODY2), notably the factors associated with deterioration of hyperglycemia over time. RESEARCH DESIGN AND METHODS:We report an 11-year follow-up of glucose tolerance and indexes of insulin secretion ...

    journal_title:Diabetes care

    pub_type: 杂志文章


    authors: Martin D,Bellanné-Chantelot C,Deschamps I,Froguel P,Robert JJ,Velho G

    更新日期:2008-07-01 00:00:00

  • Dose response of inhaled dry-powder insulin and dose equivalence to subcutaneous insulin lispro.

    abstract:OBJECTIVE:To determine the pharmacokinetic (PK) and glucodynamic (GD) dose response of human insulin inhalation powder (HIIP) delivered via AIR particle technology and dose equivalence to subcutaneous (SC) insulin lispro. RESEARCH DESIGN AND METHODS:Twenty healthy, nonsmoking, male or female subjects (aged 29.6 +/- 6....

    journal_title:Diabetes care

    pub_type: 杂志文章,随机对照试验


    authors: Rave KM,Nosek L,de la Peña A,Seger M,Ernest CS 2nd,Heinemann L,Batycky RP,Muchmore DB

    更新日期:2005-10-01 00:00:00

  • Signs of beta-cell autoimmunity in nondiabetic schoolchildren: a comparison between Russian Karelia with a low incidence of type 1 diabetes and Finland with a high incidence rate.

    abstract:OBJECTIVE:We sought to study the prevalence of autoantibodies to various islet cell antigens in the background population of two neighboring countries with a sixfold difference in the incidence of type 1 diabetes. RESEARCH DESIGN AND METHODS:Serum samples were obtained from 3,652 nondiabetic schoolchildren in Finland ...

    journal_title:Diabetes care

    pub_type: 杂志文章,多中心研究


    authors: Kondrashova A,Viskari H,Kulmala P,Romanov A,Ilonen J,Hyöty H,Knip M

    更新日期:2007-01-01 00:00:00

  • Correlation of fingerstick blood glucose measurements with GlucoWatch biographer glucose results in young subjects with type 1 diabetes.

    abstract:OBJECTIVE:The purpose of this study was to compare measurements of glucose obtained via iontophoretic extraction with the GlucoWatch automatic glucose biographer (Cygnus, Inc., Redwood City, CA) with capillary blood glucose values that were determined 1) in a controlled outpatient clinic setting and 2) in a home settin...

    journal_title:Diabetes care

    pub_type: 临床试验,杂志文章


    authors: Garg SK,Potts RO,Ackerman NR,Fermi SJ,Tamada JA,Chase HP

    更新日期:1999-10-01 00:00:00

  • Relationship between hypoglycemic episodes and ventricular arrhythmias in patients with type 2 diabetes and cardiovascular diseases: silent hypoglycemias and silent arrhythmias.

    abstract:OBJECTIVE:In patients with type 2 diabetes and cardiovascular diseases (CVDs), intensive treatment with insulin and/or sulfonylurea (SU) may be associated with excessive increased risk of hypoglycemic episodes. To evaluate the risk of critical arrhythmias related to glycemic variability, we carried out an observational...

    journal_title:Diabetes care

    pub_type: 杂志文章


    authors: Stahn A,Pistrosch F,Ganz X,Teige M,Koehler C,Bornstein S,Hanefeld M

    更新日期:2014-02-01 00:00:00

  • Predicting the optimal basal insulin infusion pattern in children and adolescents on insulin pumps.

    abstract:OBJECTIVE:We aimed at developing and cross-validating a mathematical prediction model for an optimal basal insulin infusion pattern for children with type 1 diabetes on continuous subcutaneous insulin infusion therapy (CSII). RESEARCH DESIGN AND METHODS:We used the German/Austrian DPV-Wiss database for quality control...

    journal_title:Diabetes care

    pub_type: 杂志文章


    authors: Holterhus PM,Bokelmann J,Riepe F,Heidtmann B,Wagner V,Rami-Merhar B,Kapellen T,Raile K,Quester W,Holl RW,German\/Austrian DPV-Initiative and the German Pediatric CSII Working Group.

    更新日期:2013-06-01 00:00:00

  • Efficacy and safety of inhaled insulin (exubera) compared with subcutaneous insulin therapy in patients with type 2 diabetes: results of a 6-month, randomized, comparative trial.

    abstract:OBJECTIVE:Glycemic control using inhaled, dry-powder insulin plus a single injection of long-acting insulin was compared with a conventional regimen in patients with type 2 diabetes, which was previously managed with at least two daily insulin injections. RESEARCH DESIGN AND METHODS:Patients were randomized to 6 month...

    journal_title:Diabetes care

    pub_type: 临床试验,杂志文章,多中心研究,随机对照试验


    authors: Hollander PA,Blonde L,Rowe R,Mehta AE,Milburn JL,Hershon KS,Chiasson JL,Levin SR

    更新日期:2004-10-01 00:00:00

  • Efficacy and safety of dulaglutide versus sitagliptin after 52 weeks in type 2 diabetes in a randomized controlled trial (AWARD-5).

    abstract:OBJECTIVE:To compare the efficacy and safety of two doses of once-weekly dulaglutide, a glucagon-like peptide 1 receptor agonist, to sitagliptin in uncontrolled, metformin-treated patients with type 2 diabetes. The primary objective was to compare (for noninferiority and then superiority) dulaglutide 1.5 mg versus sita...

    journal_title:Diabetes care

    pub_type: 杂志文章,随机对照试验


    authors: Nauck M,Weinstock RS,Umpierrez GE,Guerci B,Skrivanek Z,Milicevic Z

    更新日期:2014-08-01 00:00:00

  • Ethnic variation in adiponectin and leptin levels and their association with adiposity and insulin resistance.

    abstract:OBJECTIVE:To investigate ethnic differences in adiponectin and leptin concentration and to determine whether these adipokines and a high-glycemic index diet account for ethnic variation in insulin resistance. RESEARCH DESIGN AND METHODS:In 1,176 South Asian, Chinese, Aboriginal, and European Canadians, fasting blood s...

    journal_title:Diabetes care

    pub_type: 杂志文章


    authors: Mente A,Razak F,Blankenberg S,Vuksan V,Davis AD,Miller R,Teo K,Gerstein H,Sharma AM,Yusuf S,Anand SS,Study of the Health Assessment And Risk Evaluation.,Study of the Health Assessment And Risk Evaluation in Aboriginal Peoples Inv

    更新日期:2010-07-01 00:00:00

  • U-500 regular insulin: clinical experience and pharmacokinetics in obese, severely insulin-resistant type 2 diabetic patients.

    abstract:OBJECTIVE:To describe the clinical experience and the pharmacokinetics of U-500 regular insulin in severely insulin-resistant obese type 2 diabetic patients. RESEARCH DESIGN AND METHODS:Patients requiring >200 units of insulin with A1C levels >8.0% were switched to U-500 regular insulin. For the pharmacokinetic study,...

    journal_title:Diabetes care

    pub_type: 杂志文章


    authors: Davidson MB,Navar MD,Echeverry D,Duran P

    更新日期:2010-02-01 00:00:00

  • Receptor binding and effect of biosynthetic human insulin on 2-deoxyglucose transport.

    abstract::Biosynthetic human insulin (BHI) and purified pork insulin (PPI) were compared for binding properties and stimulatory effect on 2-deoxyglucose transport in isolated rat fat cells. No difference between these types of insulin could be demonstrated. ...

    journal_title:Diabetes care

    pub_type: 杂志文章


    authors: Wieringa T,van Putten JP,Van Dijk-Besling M,Krans HM

    更新日期:1981-03-01 00:00:00