41 Prevalence of Diabetes Among Veterans by Sexual Orientation

OBJECTIVES/GOALS: There is evidence that lesbian, gay, and bisexual (LGB) adults have poorer cardiovascular health than their heterosexual peers, but studies of the association between sexual orientation (SO) and diabetes mellitus (DM) have been few with mixed findings. To further investigate this a...

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Main Authors: Meredith Duncan, Carl G. Streed, Lauren B. Beach, John R. O’Leary, Melissa Skanderson, Joseph L. Goulet
Format: Article
Language:English
Published: Cambridge University Press 2023-04-01
Series:Journal of Clinical and Translational Science
Online Access:https://www.cambridge.org/core/product/identifier/S2059866123001334/type/journal_article
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author Meredith Duncan
Carl G. Streed
Lauren B. Beach
John R. O’Leary
Melissa Skanderson
Joseph L. Goulet
author_facet Meredith Duncan
Carl G. Streed
Lauren B. Beach
John R. O’Leary
Melissa Skanderson
Joseph L. Goulet
author_sort Meredith Duncan
collection DOAJ
description OBJECTIVES/GOALS: There is evidence that lesbian, gay, and bisexual (LGB) adults have poorer cardiovascular health than their heterosexual peers, but studies of the association between sexual orientation (SO) and diabetes mellitus (DM) have been few with mixed findings. To further investigate this association, large cohorts with objective data capture are needed. METHODS/STUDY POPULATION: We used data from the Veterans Healthcare Administration Lesbian, Gay, Bisexual, Transgender EHR cohort which includes veterans with at least 2 encounters October 1, 2009-September 30, 2019. The first clinic visit in this window was the index date with the baseline date one year later; the intervening year served as a baseline period for observation of prevalent disease and comorbidities. We did not include transgender veterans in this analysis in order to focus on SO rather than on the intersection of SO with gender identity. The SO of 1,108,990 veterans was identified using a natural language processing tool; 185,788 veterans were classified as LGB. We first examined sample characteristics by sex and SO and then used logistic regression to assess the association between SO and prevalent DM. RESULTS/ANTICIPATED RESULTS: DM was present among 193,330 veterans (32,986 LGB). Mean age was similar across SO in women (41) and men (53). Distribution of race was similar across groups, but LGB veterans were more likely to be Hispanic (11%, both sexes) than non-LGB men (6%) and women (8%). Current smoking was more prevalent among LGB (44% men, 39% women) than non-LGB veterans (40% men, 30% women). Adjusting for age, sex, race, Hispanic ethnicity, BMI, smoking status, health insurance, marital status, and enrollment priority, LGB veterans had 1.12 [1.10, 1.13] times the odds of DM vs. non-LGB veterans. Bisexual (0.87 [0.74, 1.01]) or lesbian (1.03 [0.97, 1.10]) women did not have significantly different DM odds than non-LGB women. Bisexual men had lower DM odds (0.86 [0.80, 0.93]) while gay men had higher odds (1.04 [1.01, 1.06]) than non-LGB men. DISCUSSION/SIGNIFICANCE: This is one of the first studies to report DM in a veteran cohort stratified by SO. Our findings highlight the importance of examining SO groups separately and jointly, as to further elucidate the association between SO, cardiovascular risk factors, and general cardiovascular health. Future work will examine the intersection of SO and gender identity.
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spelling doaj.art-52da2aacf42b47b5b31b7cdf583cab072023-04-24T05:55:56ZengCambridge University PressJournal of Clinical and Translational Science2059-86612023-04-017101110.1017/cts.2023.13341 Prevalence of Diabetes Among Veterans by Sexual OrientationMeredith Duncan0Carl G. Streed1Lauren B. Beach2John R. O’Leary3Melissa Skanderson4Joseph L. Goulet5University of KentuckyMedical Center, Boston UniversityFeinberg School of Medicine, Northwestern UniversityYale UniversityYale UniversityYale UniversityOBJECTIVES/GOALS: There is evidence that lesbian, gay, and bisexual (LGB) adults have poorer cardiovascular health than their heterosexual peers, but studies of the association between sexual orientation (SO) and diabetes mellitus (DM) have been few with mixed findings. To further investigate this association, large cohorts with objective data capture are needed. METHODS/STUDY POPULATION: We used data from the Veterans Healthcare Administration Lesbian, Gay, Bisexual, Transgender EHR cohort which includes veterans with at least 2 encounters October 1, 2009-September 30, 2019. The first clinic visit in this window was the index date with the baseline date one year later; the intervening year served as a baseline period for observation of prevalent disease and comorbidities. We did not include transgender veterans in this analysis in order to focus on SO rather than on the intersection of SO with gender identity. The SO of 1,108,990 veterans was identified using a natural language processing tool; 185,788 veterans were classified as LGB. We first examined sample characteristics by sex and SO and then used logistic regression to assess the association between SO and prevalent DM. RESULTS/ANTICIPATED RESULTS: DM was present among 193,330 veterans (32,986 LGB). Mean age was similar across SO in women (41) and men (53). Distribution of race was similar across groups, but LGB veterans were more likely to be Hispanic (11%, both sexes) than non-LGB men (6%) and women (8%). Current smoking was more prevalent among LGB (44% men, 39% women) than non-LGB veterans (40% men, 30% women). Adjusting for age, sex, race, Hispanic ethnicity, BMI, smoking status, health insurance, marital status, and enrollment priority, LGB veterans had 1.12 [1.10, 1.13] times the odds of DM vs. non-LGB veterans. Bisexual (0.87 [0.74, 1.01]) or lesbian (1.03 [0.97, 1.10]) women did not have significantly different DM odds than non-LGB women. Bisexual men had lower DM odds (0.86 [0.80, 0.93]) while gay men had higher odds (1.04 [1.01, 1.06]) than non-LGB men. DISCUSSION/SIGNIFICANCE: This is one of the first studies to report DM in a veteran cohort stratified by SO. Our findings highlight the importance of examining SO groups separately and jointly, as to further elucidate the association between SO, cardiovascular risk factors, and general cardiovascular health. Future work will examine the intersection of SO and gender identity.https://www.cambridge.org/core/product/identifier/S2059866123001334/type/journal_article
spellingShingle Meredith Duncan
Carl G. Streed
Lauren B. Beach
John R. O’Leary
Melissa Skanderson
Joseph L. Goulet
41 Prevalence of Diabetes Among Veterans by Sexual Orientation
Journal of Clinical and Translational Science
title 41 Prevalence of Diabetes Among Veterans by Sexual Orientation
title_full 41 Prevalence of Diabetes Among Veterans by Sexual Orientation
title_fullStr 41 Prevalence of Diabetes Among Veterans by Sexual Orientation
title_full_unstemmed 41 Prevalence of Diabetes Among Veterans by Sexual Orientation
title_short 41 Prevalence of Diabetes Among Veterans by Sexual Orientation
title_sort 41 prevalence of diabetes among veterans by sexual orientation
url https://www.cambridge.org/core/product/identifier/S2059866123001334/type/journal_article
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