Racial and Ethnic Disparities in Glycemic Control Among Patients With SARS-CoV-2 in the Baltimore–Washington, District of Columbia Region
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...
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| Format: | Article |
| Language: | English |
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Elsevier
2024-02-01
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| Series: | AJPM Focus |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2773065423000937 |
| _version_ | 1827374860427329536 |
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| author | Cassandra Parent, BS Diego A. Martinez, PhD Maya Venkataramani, MD, MPH Cui Yang, PhD Kathleen R. Page, MD |
| author_facet | Cassandra Parent, BS Diego A. Martinez, PhD Maya Venkataramani, MD, MPH Cui Yang, PhD Kathleen R. Page, MD |
| author_sort | Cassandra Parent, BS |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-03-08T11:41:09Z |
| format | Article |
| id | doaj.art-397af5eece1547cc996f0710db7d0ef2 |
| institution | Directory Open Access Journal |
| issn | 2773-0654 |
| language | English |
| last_indexed | 2024-03-08T11:41:09Z |
| publishDate | 2024-02-01 |
| publisher | Elsevier |
| record_format | Article |
| series | AJPM Focus |
| spelling | doaj.art-397af5eece1547cc996f0710db7d0ef22024-01-25T05:24:37ZengElsevierAJPM Focus2773-06542024-02-0131100156Racial and Ethnic Disparities in Glycemic Control Among Patients With SARS-CoV-2 in the Baltimore–Washington, District of Columbia RegionCassandra Parent, BS0Diego A. Martinez, PhD1Maya Venkataramani, MD, MPH2Cui Yang, PhD3Kathleen R. Page, MD4Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MarylandSchool of Industrial Engineering, Pontificia Universidad Católica de Valparaíso, Valparaíso, Chile; Department of Emergency Medicine, Johns Hopkins University School of Medicine, Baltimore, MarylandDivision of General Internal Medicine, Johns Hopkins School of Medicine, Baltimore, MarylandDepartment of Health Behavior, Society and Policy, Rutgers School of Public Health, Piscataway, New JerseyDepartment of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland; Address correspondence to: Kathleen R. Page, MD, Department of Medicine, Johns Hopkins University School of Medicine, 600 North Wolfe Street Phipps 524, Baltimore MD 21287.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.http://www.sciencedirect.com/science/article/pii/S2773065423000937DiabetesCOVID-19immigrationhealth disparitiesLatinos |
| spellingShingle | Cassandra Parent, BS Diego A. Martinez, PhD Maya Venkataramani, MD, MPH Cui Yang, PhD Kathleen R. Page, MD Racial and Ethnic Disparities in Glycemic Control Among Patients With SARS-CoV-2 in the Baltimore–Washington, District of Columbia Region AJPM Focus Diabetes COVID-19 immigration health disparities Latinos |
| title | Racial and Ethnic Disparities in Glycemic Control Among Patients With SARS-CoV-2 in the Baltimore–Washington, District of Columbia Region |
| title_full | Racial and Ethnic Disparities in Glycemic Control Among Patients With SARS-CoV-2 in the Baltimore–Washington, District of Columbia Region |
| title_fullStr | Racial and Ethnic Disparities in Glycemic Control Among Patients With SARS-CoV-2 in the Baltimore–Washington, District of Columbia Region |
| title_full_unstemmed | Racial and Ethnic Disparities in Glycemic Control Among Patients With SARS-CoV-2 in the Baltimore–Washington, District of Columbia Region |
| title_short | Racial and Ethnic Disparities in Glycemic Control Among Patients With SARS-CoV-2 in the Baltimore–Washington, District of Columbia Region |
| title_sort | racial and ethnic disparities in glycemic control among patients with sars cov 2 in the baltimore washington district of columbia region |
| topic | Diabetes COVID-19 immigration health disparities Latinos |
| url | http://www.sciencedirect.com/science/article/pii/S2773065423000937 |
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