Racial and ethnic disparities in the pharmacologic management of diabetes mellitus among long-term care facility residents

Abstract

Objective: To evaluate the prevalence of racial and ethnic disparities of antidiabetic treatment among residents of long-term care facilities in five states.

Research design and methods: Retrospective, cross-sectional study of 50,427 elderly nursing home residents with diabetes in New York, South Dakota, Kansas, Mississippi, and Ohio between 1993 and 1997.

Results: Thirty to fifty percent of residents received no antidiabetic medications. After adjusting for sociodemographic characteristics, comorbid conditions and diabetes severity, Blacks and Hispanics had lower rates of antidiabetic medication use than Whites, while Asians had slightly higher rates. For Native Americans the results were mixed, little disparity was seen when compared with Whites observed among New York nursing home residents, and while in South Dakota Native Americans had significantly lower rates of antidiabetic medication use than Whites.

Conclusion: Although lack of information on glycemic control and non-medical treatments do not allow us to comment on quality of diabetes care, more research is needed to understand why some nursing homes residents are less likely to receive antidiabetic medication.