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














  • Smoking and mortality among women with type 2 diabetes: The Nurses' Health Study cohort.

    abstract:OBJECTIVE:To assess the relationship between cigarette smoking and mortality among women with type 2 diabetes in the Nurses' Health Study cohort. RESEARCH DESIGN AND METHODS:The Nurses' Health Study, a prospective cohort of U.S. female registered nurses, included 7,401 women with type 2 diabetes diagnosed at baseline ...

    journal_title:Diabetes care

    pub_type: 杂志文章


    authors: Al-Delaimy WK,Willett WC,Manson JE,Speizer FE,Hu FB

    更新日期:2001-12-01 00:00:00

  • Periodontal infection, systemic inflammation, and insulin resistance: results from the continuous National Health and Nutrition Examination Survey (NHANES) 1999-2004.

    abstract:OBJECTIVE:Adverse microbial exposures might contribute to diabetogenesis. We hypothesized that clinical periodontal disease (a manifestation of microbial exposures in dysbiotic biofilms) would be related to insulin resistance among diabetes-free participants. The roles of inflammatory mediation and effect modification ...

    journal_title:Diabetes care

    pub_type: 杂志文章


    authors: Demmer RT,Squillaro A,Papapanou PN,Rosenbaum M,Friedewald WT,Jacobs DR Jr,Desvarieux M

    更新日期:2012-11-01 00:00:00

  • Prospective evaluation of HDL cholesterol changes after diet and physical conditioning programs for patients with type II diabetes mellitus.

    abstract::High-density lipoprotein (HDL) cholesterol is known to be low in patients with diabetes mellitus. Low HDL levels are correlated with premature cardiovascular mortality in several major epidemiologic studies and many investigators believe increases in HDL cholesterol may reduce the risk of coronary heart disease. We ev...

    journal_title:Diabetes care

    pub_type: 临床试验,杂志文章,随机对照试验


    authors: Kaplan RM,Wilson DK,Hartwell SL,Merino KL,Wallace JP

    更新日期:1985-07-01 00:00:00

  • Impact of specific glucose-control strategies on microvascular and macrovascular outcomes in 58,000 adults with type 2 diabetes.

    abstract:OBJECTIVE:Comparative effectiveness research methods are used to compare the effect of four distinct glucose-control strategies on subsequent myocardial infarction and nephropathy in type 2 diabetes. RESEARCH DESIGN AND METHODS:A total of 58,000 adults with type 2 diabetes and A1C <7% (53 mmol/mol) while taking two or...

    journal_title:Diabetes care

    pub_type: 杂志文章


    authors: Neugebauer R,Fireman B,Roy JA,O'Connor PJ

    更新日期:2013-11-01 00:00:00

  • Comparison of A1C and fasting glucose criteria to diagnose diabetes among U.S. adults.

    abstract:OBJECTIVE:To compare A1C and fasting glucose for the diagnosis of diabetes among U.S. adults. RESEARCH DESIGN AND METHODS:This study included 6,890 adults (> or =20 years of age) from the 1999-2006 National Health and Nutrition Examination Survey without a self-reported history of diabetes who had fasted > or =9 h. A1...

    journal_title:Diabetes care

    pub_type: 杂志文章


    authors: Carson AP,Reynolds K,Fonseca VA,Muntner P

    更新日期:2010-01-01 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

  • Reconciliation of Type 2 Diabetes Remission Rates in Studies of Roux-en-Y Gastric Bypass.

    abstract:OBJECTIVE:Bariatric surgery may induce remission of type 2 diabetes in obese patients. However, estimates of remission rates reported in the literature range from 25 to 81%, contributing to the uncertainty patients and physicians both face as they assess treatment options. This analysis attempts to reconcile the seemin...

    journal_title:Diabetes care

    pub_type: 杂志文章


    authors: Isaman DJ,Rothberg AE,Herman WH

    更新日期:2016-12-01 00:00:00

  • Evaluation of two methods of self blood glucose monitoring by trained insulin-dependent diabetic adolescents outside the hospital.

    abstract::We studied the accuracy of the Chemstrip bG and Glucometer systems in the self-monitoring of blood glucose by trained adolescents. The determinations were done at home with simultaneous collection of whole blood into capillary tubes (Sarstedt) which were later analyzed by a glucose-oxidase analyzer (Beckman Instrument...

    journal_title:Diabetes care

    pub_type: 杂志文章


    authors: Schiffrin A,Desrosiers M,Belmonte M

    更新日期:1983-03-01 00:00:00

  • Diabetes, Associated Clinical Spectrum, Long-term Prognosis, and Genotype/Phenotype Correlations in 201 Adult Patients With Hepatocyte Nuclear Factor 1B (HNF1B) Molecular Defects.

    abstract:OBJECTIVE:Molecular defects of hepatocyte nuclear factor 1B (HNF1B) are associated with a multiorgan disease, including diabetes (maturity-onset diabetes of the young 5) and kidney abnormalities. The HNF1B syndrome is related to HNF1B mutations or to a 17q12 deletion spanning 15 genes, including HNF1B. Here, we describ...

    journal_title:Diabetes care

    pub_type: 杂志文章,多中心研究


    authors: Dubois-Laforgue D,Cornu E,Saint-Martin C,Coste J,Bellanné-Chantelot C,Timsit J,Monogenic Diabetes Study Group of the Société Francophone du Diabète.

    更新日期:2017-11-01 00:00:00

  • Circulating and dietary trans fatty acids and incident type 2 diabetes in older adults: the Cardiovascular Health Study.

    abstract:OBJECTIVE:To investigate the effects of trans fatty acids (TFAs) on type 2 diabetes mellitus (DM) by specific TFA subtype or method of assessment. RESEARCH DESIGN AND METHODS:In the Cardiovascular Health Study, plasma phospholipid trans (t)-16:1n9, t-18:1, and cis (c)/t-, t/c-, and t/t-18:2 were measured in blood draw...

    journal_title:Diabetes care

    pub_type: 杂志文章,多中心研究,随机对照试验


    authors: Wang Q,Imamura F,Ma W,Wang M,Lemaitre RN,King IB,Song X,Biggs ML,Delaney JA,Mukamal KJ,Djousse L,Siscovick DS,Mozaffarian D

    更新日期:2015-06-01 00:00:00

  • Erythromycin derivative improves gastric emptying and insulin requirement in diabetic patients with gastroparesis.

    abstract:OBJECTIVE:To evaluate the effect of the erythromycin derivative EM523L on gastric emptying and postprandial insulin requirement in insulin-dependent diabetic patients with severe gastroparesis. RESEARCH DESIGN AND METHODS:In six IDDM patients with severe gastroparesis (two men and four women, mean age 44.5 years [rang...

    journal_title:Diabetes care

    pub_type: 临床试验,杂志文章


    authors: Ishii M,Nakamura T,Kasai F,Baba T,Takebe K

    更新日期:1997-07-01 00:00:00

  • Use of Antihyperglycemic Medications in U.S. Adults: An Analysis of the National Health and Nutrition Examination Survey.

    abstract:OBJECTIVE:1) To examine trends in the use of diabetes medications and 2) to determine whether physicians individualize diabetes treatment as recommended by the American Diabetes Association (ADA). RESEARCH DESIGN AND METHODS:We conducted a retrospective, cross-sectional analysis of 2003-2016 National Health and Nutrit...

    journal_title:Diabetes care

    pub_type: 杂志文章


    authors: Le P,Chaitoff A,Misra-Hebert AD,Ye W,Herman WH,Rothberg MB

    更新日期:2020-06-01 00:00:00

  • Reversion of β-Cell Autoimmunity Changes Risk of Type 1 Diabetes: TEDDY Study.

    abstract:OBJECTIVE:β-Cell autoantibodies are a feature of the preclinical phase of type 1 diabetes. Here, we asked how frequently they revert in a cohort of children at risk for type 1 diabetes and whether reversion has any effect on type 1 diabetes risk. RESEARCH DESIGN AND METHODS:Children were up to 10 years of age and scre...

    journal_title:Diabetes care

    pub_type: 杂志文章


    authors: Vehik K,Lynch KF,Schatz DA,Akolkar B,Hagopian W,Rewers M,She JX,Simell O,Toppari J,Ziegler AG,Lernmark Å,Bonifacio E,Krischer JP,TEDDY Study Group.

    更新日期:2016-09-01 00:00:00

  • Effect of chronic intermittent intravenous insulin therapy on antihypertensive medication requirements in IDDM subjects with hypertension and nephropathy.

    abstract:OBJECTIVE:The prevalence of systemic hypertension is increased in patients with diabetes. In this prospective, randomized, crossover clinical trial, we assessed antihypertensive effects of chronic intermittent intravenous insulin therapy (CIIIT) on insulin-dependent diabetes mellitus (IDDM) subjects with hypertension a...

    journal_title:Diabetes care

    pub_type: 临床试验,杂志文章,随机对照试验


    authors: Aoki TT,Grecu EO,Prendergast JJ,Arcangeli MA,Meisenheimer R

    更新日期:1995-09-01 00:00:00

  • Haptoglobin genotype is predictive of major adverse cardiac events in the 1-year period after percutaneous transluminal coronary angioplasty in individuals with diabetes.

    abstract:OBJECTIVE:The goal of this study was to determine whether the haptoglobin (Hp) genotype was predictive of restenosis and major adverse cardiac events (MACEs) after percutaneous transluminal coronary angioplasty (PTCA) in individuals with diabetes. RESEARCH DESIGN AND METHODS:A consecutive series of 935 diabetic patien...

    journal_title:Diabetes care

    pub_type: 杂志文章


    authors: Roguin A,Koch W,Kastrati A,Aronson D,Schomig A,Levy AP

    更新日期:2003-09-01 00:00:00

  • Patients With Diabetes Without Significant Angiographic Coronary Artery Disease Have the Same Risk of Myocardial Infarction as Patients Without Diabetes in a Real-World Population Receiving Appropriate Prophylactic Treatment.

    abstract:OBJECTIVE:The risk of myocardial infarction (MI) in patients with diabetes is greater than for patients without diabetes. Consequently, prophylactic treatment is recommended for patients with diabetes and risk factors for ischemic heart disease. We aimed to estimate the risk of adverse cardiac events in patients with a...

    journal_title:Diabetes care

    pub_type: 杂志文章


    authors: Olesen KKW,Madsen M,Egholm G,Thim T,Jensen LO,Raungaard B,Bøtker HE,Sørensen HT,Maeng M

    更新日期:2017-08-01 00:00:00

  • Islet cell antibody-positive versus -negative phenotypic type 2 diabetes in youth: does the oral glucose tolerance test distinguish between the two?

    abstract::OBJECTIVE Using the clamp technique, youths with a clinical diagnosis of type 2 diabetes (CDx-type 2 diabetes) and positive pancreatic autoantibodies (Ab(+)) were shown to have severe impairment in insulin secretion and less insulin resistance than their peers with negative antibodies (Ab(-)). In this study, we invest...

    journal_title:Diabetes care

    pub_type: 杂志文章


    authors: Tfayli H,Bacha F,Gungor N,Arslanian S

    更新日期:2010-03-01 00:00:00

  • Challenges to healthy eating for people with diabetes in a low-income, minority neighborhood.

    abstract:OBJECTIVE:This study used qualitative interviews with black and Latino participants with diabetes to further understanding about types of foods eaten, food preparation, sources of foods and meals, communication with providers, and effects of race and ethnicity on eating in this population. RESEARCH DESIGN AND METHODS:...

    journal_title:Diabetes care

    pub_type: 杂志文章


    authors: Breland JY,McAndrew LM,Gross RL,Leventhal H,Horowitz CR

    更新日期:2013-10-01 00:00:00

  • Metabolic Syndrome Components Are Associated With Symptomatic Polyneuropathy Independent of Glycemic Status.

    abstract:OBJECTIVE:Previous studies demonstrate that the metabolic syndrome is associated with distal symmetric polyneuropathy (DSP). We aimed to determine the magnitude of this effect and the precise components involved. RESEARCH DESIGN AND METHODS:We determined the symptomatic DSP prevalence in the Health, Aging, and Body Co...

    journal_title:Diabetes care

    pub_type: 杂志文章


    authors: Callaghan BC,Xia R,Banerjee M,de Rekeneire N,Harris TB,Newman AB,Satterfield S,Schwartz AV,Vinik AI,Feldman EL,Strotmeyer ES,Health ABC Study.

    更新日期:2016-05-01 00:00:00

  • A quantitative scale of acanthosis nigricans.

    abstract:OBJECTIVE:To develop and validate a scale for acanthosis nigricans (AN). RESEARCH DESIGN AND METHODS:Subjects were participants from the San Antonio Family Diabetes Study and the San Antonio Family Heart Study. A total of 406 subjects were independently examined for AN by at least two observers. Five locations were ex...

    journal_title:Diabetes care

    pub_type: 杂志文章


    authors: Burke JP,Hale DE,Hazuda HP,Stern MP

    更新日期:1999-10-01 00:00:00

  • Association of Blood Glucose Control and Lipids With Diabetic Retinopathy in the Veterans Affairs Diabetes Trial (VADT).

    abstract:OBJECTIVE:This study examined whether lipids modify the relationship between intensive glucose control (INT) and diabetic retinopathy (DR). RESEARCH DESIGN AND METHODS:The incidence and progression of DR were assessed in 858 of 1,791 participants with 7-field stereoscopic fundus photographs at baseline and 5 years lat...

    journal_title:Diabetes care

    pub_type: 杂志文章,随机对照试验


    authors: Azad N,Bahn GD,Emanuele NV,Agrawal L,Ge L,Reda D,Klein R,Reaven PD,Hayward R,VADT Study Group.

    更新日期:2016-05-01 00:00:00

  • Adolescent Type 1 Diabetes Cardio-Renal Intervention Trial (AdDIT): urinary screening and baseline biochemical and cardiovascular assessments.

    abstract:OBJECTIVE:We assessed the association between early increases in albumin excretion and cardiovascular (CV) and renal markers in a large cohort of young people with type 1 diabetes. RESEARCH DESIGN AND METHODS:As part of preliminary screening for a multicenter, randomized controlled trial of statins/ACE inhibitors, we ...

    journal_title:Diabetes care

    pub_type: 杂志文章,多中心研究,随机对照试验


    authors: Marcovecchio ML,Woodside J,Jones T,Daneman D,Neil A,Prevost T,Dalton RN,Deanfield J,Dunger DB,AdDIT Investigators.

    更新日期:2014-01-01 00:00:00

  • Diabetes and risk of Parkinson's disease: a systematic review and meta-analysis.

    abstract:OBJECTIVE:Diabetes has been associated with chronic neurodegeneration. We performed a systematic review and meta-analysis to assess the relationship between pre-existing diabetes and Parkinson's disease (PD). RESEARCH DESIGN AND METHODS:Original articles in English published up to 10 May 2011 were searched for in elec...

    journal_title:Diabetes care

    pub_type: 杂志文章,meta分析,评审


    authors: Cereda E,Barichella M,Pedrolli C,Klersy C,Cassani E,Caccialanza R,Pezzoli G

    更新日期:2011-12-01 00:00:00

  • Diabetes and Prediabetes and Risk of Hospitalization: The Atherosclerosis Risk in Communities (ARIC) Study.

    abstract:OBJECTIVE:To examine the magnitude and types of hospitalizations among persons with prediabetes, undiagnosed diabetes, and diagnosed diabetes. RESEARCH DESIGN AND METHODS:This study included 13,522 participants in the Atherosclerosis Risk in Communities (ARIC) study (mean age 57 years, 56% female, 24% black, 18% with ...

    journal_title:Diabetes care

    pub_type: 杂志文章


    authors: Schneider AL,Kalyani RR,Golden S,Stearns SC,Wruck L,Yeh HC,Coresh J,Selvin E

    更新日期:2016-05-01 00:00:00

  • Role of liver in pathophysiology of NIDDM.

    abstract::Glucose homeostasis is physiologically maintained by the balance between glucose production by the liver and glucose utilization by the peripheral tissues. Insulin controls hepatic glucose production and promotes glucose utilization by the skeletal muscle. In non-insulin-dependent diabetes mellitus (NIDDM), postabsorp...

    journal_title:Diabetes care

    pub_type: 杂志文章,评审


    authors: Consoli A

    更新日期:1992-03-01 00:00:00

  • Clinical utility of nonenzymatically glycosylated blood proteins as an index of glucose control.

    abstract::This study compares the utility of nonenzymatically glycosylated serum proteins (lys-GSP) to glycosylated hemoglobins (HbA1a-c) as control indices of glucose homeostasis in patients with IDDM. The diagnostic value of lys-GSP was also examined in patients with non-insulin-dependent diabetes mellitus, in subjects with i...

    journal_title:Diabetes care

    pub_type: 杂志文章


    authors: Schleicher ED,Gerbitz KD,Dolhofer R,Reindl E,Wieland OH,Edelmann E,Haslbeck M,Kemmler W,Walter H,Mehnert H

    更新日期:1984-11-01 00:00:00

  • Effects of metformin on insulin resistance, risk factors for cardiovascular disease, and plasminogen activator inhibitor in NIDDM subjects. A study of two ethnic groups.

    abstract:OBJECTIVE:To investigate the effects of metformin on glycemic control, insulin resistance, and risk factors for cardiovascular disease in NIDDM subjects from two ethnic groups (Caucasian and Asian) with different risks of cardiovascular disease. RESEARCH DESIGN AND METHODS:A total of 27 subjects with NIDDM (17 Caucasi...

    journal_title:Diabetes care

    pub_type: 临床试验,评论,杂志文章,随机对照试验


    authors: Nagi DK,Yudkin JS

    更新日期:1993-04-01 00:00:00

  • Contribution of nerve-axon reflex-related vasodilation to the total skin vasodilation in diabetic patients with and without neuropathy.

    abstract:OBJECTIVE:To examine the contribution of nerve-axon reflex-related vasodilation to total acetylcholine-induced vasodilation in the skin of normal and diabetic subjects. RESEARCH DESIGN AND METHODS:The skin microcirculation was evaluated at the forearm level in 69 healthy subjects and 42 nonneuropathic diabetic patient...

    journal_title:Diabetes care

    pub_type: 杂志文章


    authors: Hamdy O,Abou-Elenin K,LoGerfo FW,Horton ES,Veves A

    更新日期:2001-02-01 00:00:00

  • Plasma Fucosylated Glycans and C-Reactive Protein as Biomarkers of HNF1A-MODY in Young Adult-Onset Nonautoimmune Diabetes.

    abstract:OBJECTIVE:Maturity-onset diabetes of the young (MODY) due to variants in HNF1A is the most common type of monogenic diabetes. Frequent misdiagnosis results in missed opportunity to use sulfonylureas as first-line treatment. A nongenetic biomarker could improve selection of subjects for genetic testing and increase diag...

    journal_title:Diabetes care

    pub_type: 杂志文章


    authors: Juszczak A,Pavić T,Vučković F,Bennett AJ,Shah N,Pape Medvidović E,Groves CJ,Šekerija M,Chandler K,Burrows C,Rojnić Putarek N,Vučić Lovrenčić M,Ćuća Knežević J,James TJ,Gloyn AL,Lauc G,McCarthy MI,Owen KR,Gornik O

    更新日期:2019-01-01 00:00:00

  • The antidiabetogenic effect of GLP-1 is maintained during a 7-day treatment period and improves diabetic dyslipoproteinemia in NIDDM patients.

    abstract:OBJECTIVE:To investigate the long-term antidiabetogenic effect of glucagon-like peptide 1 (GLP-1) and its influence on diabetic dyslipoproteinemia, patients with NIDDM were treated with GLP-1 subcutaneously for 1 week. RESEARCH DESIGN AND METHODS:Twelve patients participated in the study. The 1st week of the study, al...

    journal_title:Diabetes care

    pub_type: 临床试验,杂志文章,随机对照试验


    authors: Juntti-Berggren L,Pigon J,Karpe F,Hamsten A,Gutniak M,Vignati L,Efendic S

    更新日期:1996-11-01 00:00:00