Racial and Ethnic Disparities in Glycemic Control Among Patients With SARS-CoV-2 in the Baltimore–Washington, District of Columbia Region
Date:
10/08/2023
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Citation:
Parent C, Martinez DA, Venkataramani M, Yang C, Page KR. Racial and Ethnic Disparities in Glycemic Control Among Patients With SARS-CoV-2 in the Baltimore-Washington, District of Columbia Region. AJPM Focus. 2023 Oct 8;3(1):100156. doi: 10.1016/j.focus.2023.100156. PMID: 38149079; PMCID: PMC10749874.
Abstract
Introduction: Diabetes is a leading risk factor for COVID-19, disproportionally impacting marginalized populations. We analyzed racial/ethnic differences in glycemic control among patients who tested positive for SARS-CoV-2 in the Baltimore–Washington, District of Columbia region.
Methods: Glycemic control measured by HbA1c was compared by race and ethnicity among patients with a positive SARS-CoV-2 test at the Johns Hopkins Health System between March 1, 2020, and March 31, 2022. Risk factors associated with poor glycemic control (HbA1c≥8) were identified using logistic regression.
Results: Black, Latino, and Asian patients had a higher rate of prediabetes (HbA1c=5.7%–6.49%) and diabetes (HbA1c≥6.5%) than non-Hispanic White patients. Among patients with diabetes, poor glycemic control (HbA1c≥8%) was significantly higher among young adults (aged ≤44 years), Latino patients (AOR=1.5; 95% CI=1.1, 1.9), Black patients (AOR=1.2; 95% CI=1.0, 1.5), uninsured patients (AOR=1.5; 95% CI=1.2, 1.9), and those with limited English proficiency (AOR=1.3; 95% CI=1.0, 1.6) or without a primary care physician (AOR=1.6; 95% CI=1.3, 2.1).
Conclusions: Disparities in glycemic control among patients who tested positive for SARS-CoV-2 were associated with underlying structural factors such as access to care, health insurance, and language proficiency. There is a need to implement accessible, culturally and language-appropriate preventive and primary care programs to engage socioeconomically disadvantaged populations in diabetic screening and care.
Methods: Glycemic control measured by HbA1c was compared by race and ethnicity among patients with a positive SARS-CoV-2 test at the Johns Hopkins Health System between March 1, 2020, and March 31, 2022. Risk factors associated with poor glycemic control (HbA1c≥8) were identified using logistic regression.
Results: Black, Latino, and Asian patients had a higher rate of prediabetes (HbA1c=5.7%–6.49%) and diabetes (HbA1c≥6.5%) than non-Hispanic White patients. Among patients with diabetes, poor glycemic control (HbA1c≥8%) was significantly higher among young adults (aged ≤44 years), Latino patients (AOR=1.5; 95% CI=1.1, 1.9), Black patients (AOR=1.2; 95% CI=1.0, 1.5), uninsured patients (AOR=1.5; 95% CI=1.2, 1.9), and those with limited English proficiency (AOR=1.3; 95% CI=1.0, 1.6) or without a primary care physician (AOR=1.6; 95% CI=1.3, 2.1).
Conclusions: Disparities in glycemic control among patients who tested positive for SARS-CoV-2 were associated with underlying structural factors such as access to care, health insurance, and language proficiency. There is a need to implement accessible, culturally and language-appropriate preventive and primary care programs to engage socioeconomically disadvantaged populations in diabetic screening and care.