Table 3.
Diabetes Management Among Participants After Diagnosis by Racial Residential Segregation and Racial Discrimination Category1,2,3,4
| Year 20 | Year 25 | |||
| N participants who developed diabetes by exam5 | 226 | 338 | ||
| N (%) participants with diabetes attending exam | 202 | 291 | ||
| N (%) participants with diabetes attending exam who self-reported a diabetes diagnosis6 | 124 | 181 | ||
| Mean (SD) | % Controlled | Mean (SD) | % Controlled | |
| Denominator for % Controlled | 124 | 181 | ||
| HbA1c (<7.0% defined as controlled) | ||||
| Overall | 7.7 (1.7) | 38.4% | 7.7 (1.8) | 45.6% |
| By Segregation Category: | ||||
| Low | 8.2 (1.6) | 23.7% | 7.6 (1.5) | 41.3% |
| Medium | 7.2 (1.5) | 48.0% | 8.1 (1.9) | 38.5% |
| High | 7.7 (1.8) | 40.6% | 7.6 (1.8) | 48.8% |
| By Racial Discrimination Category: | ||||
| No experiences | 7.8 (1.6) | 33.1% | 7.6 (1.7) | 48.2% |
| 1–2 experiences | 7.6 (1.6) | 40.5% | 7.6 (1.8) | 44.5% |
| 3+ experiences | 7.7 (1.9) | 39.9% | 7.8 (1.8) | 43.5% |
| SBP (<130 mmHg defined as controlled) | ||||
| Overall | 120.1 (15.7) | 78.2% | 123.6 (16.9) | 72.4% |
| By Segregation Category: | ||||
| Low | 120.2 (14.5) | 77.8% | 120.1 (12.3) | 80.7% |
| Medium | 116.7 (14.9) | 76.0% | 125.0 (21.1) | 70.6% |
| High | 121.2 (16.3) | 79.2% | 124.2 (16.6) | 70.7% |
| By Racial Discrimination Category: | ||||
| No experiences | 120.1 (13.4) | 83.0% | 124.4 (18.0) | 71.6% |
| 1–2 experiences | 123.4 (18.1) | 66.2% | 122.4 (15.8) | 73.3% |
| 3+ experiences | 117.4 (14.3) | 85.3% | 123.6 (16.6) | 72.6% |
| LDL cholesterol (<100 mg/dL defined as controlled) | ||||
| Overall | 102.9 (33.6) | 52.8% | 97.3 (32.8) | 55.9% |
| By Segregation Category: | ||||
| Low | 97.7 (25.1) | 52.6% | 95.0 (33.0) | 60.0% |
| Medium | 100.0 (37.4) | 47.2% | 91.3 (32.4) | 60.9% |
| High | 105.9 (34.8) | 54.9% | 99.7 (32.6) | 53.4% |
| By Racial Discrimination Category: | ||||
| No experiences | 98.5 (28.7) | 54.0% | 100.1 (33.1) | 50.6% |
| 1–2 experiences | 111.5 (38.2) | 42.6% | 95.7 (29.6) | 59.2% |
| 3+ experiences | 98.6 (31.0) | 60.5% | 95.5 (34.3) | 59.3% |
| All 3 controlled | ||||
| Overall | -- | 17.7% | -- | 21.2% |
| By Segregation Category: | ||||
| Low | -- | 5.2% | -- | 22.6% |
| Medium | -- | 23.2% | -- | 23.8% |
| High | -- | 20.6% | -- | 20.0% |
| By Racial Discrimination Category: | ||||
| No experiences | -- | 21.9% | -- | 17.9% |
| 1–2 experiences | -- | 10.7% | -- | 27.6% |
| 3+ experiences | -- | 21.0% | -- | 20.2% |
SD: standard deviation; SBP: systolic blood pressure; LDL: low density lipoprotein
Control defined as follows: HbA1c <7.0%, SBP <130 mm Hg, LDL <100 mg/dL.
Missing control values were imputed, so percentages reflect the total percent across all 10 imputed datasets. Mean values reflect averages across all 10 imputed datasets.
Racial residential segregation categorized into high, medium, and low use the value of the local Gi* statistic, which measures the deviation of the census tract’s racial composition from that of the larger metropolitan area. A Gi* statistic z-score <0 was categorized as low, 0 to 1.96 as medium, and >1.96 as high segregation.
Racial discrimination was assessed via survey. Participants reported whether they had experienced discrimination in any of 7 domains (e.g. school, getting a job, work, getting housing, getting medical care, on the street or in a public setting, from the police or in the courts). Discrimination was categorized as no experiences, 1–2 experiences, or 3+ experiences.
”Developing diabetes” was based on our definition of meeting any of the following criteria: fasting glucose ≥126 mg/dL, 2-hour glucose during the oral glucose tolerance test of ≥200 mg/dL, hemoglobin A1c ≥6.5%, or current use of medication for the treatment of diabetes mellitus. 442 participants developed diabetes during the follow-up period, and 321 of them developed diabetes by the year 25 exam and attended either the year 20 or year 25 exam.
Based on whether or not participants self-reported that a doctor or nurse ever said that they had diabetes. We conducted this analysis only among the subset who self-reported a diabetes diagnosis at the time of the exam in order to focus on participants who were aware they had diabetes prior to the exam. In total, 208 participants who developed diabetes over follow-up self-reported a diabetes diagnosis at the year 20 or year 25 exam.