Introduction: Racial and ethnic minority and socioeconomically disadvantaged populations are disproportionately burdened by type 2 diabetes (T2D). Federally Qualified Health Centers (FQHCs) provide health services to over 30 million medically underserved populations, with 63% racial and ethnic minorities and 90% at/below the federal poverty threshold.

Objective: Examine data from 35,092 adults with diabetes receiving care from an FQHC offering Diabetes Specialty Care services in San Diego, CA between 2017-2022.

Methods: Linear regression models examined clinical outcomes while controlling for sociodemographic characteristics (age, sex, race, education) and whether an endocrinologist was part of the care team.

Results: Patients were on average 60±13.1 years old, and 51% were women, 54% were Hispanic/Latino, 57% had ≤ high school education, and 7% were seen by an endocrinologist. Mean A1C was 7.9%±2.0 and systolic blood pressure (BP) was 114 mmHg±45. A1C was lower among older patients (β = -0.03, p < .0001), females (β =-0.26, p < .0001), and individuals with a college (β = -0.14, p = .001) or postgraduate (β = -0.40, p < .0001) degree. A1C was higher among patients identifying as Black (β = 0.21, p < .0001), Native American (β = 0.45, p = .011), Pacific Islander (β = 0.46, p = .0001), and Hispanic (β = 0.45, p < .0001) compared to White. BP was lower among females (β = -4.26, p < .0001) and higher among older patients (β = 0.40, p < .0001) and those identifying as Black (β = 6.94, p < .0001), Asian (β = 4.63, p < .001), and Pacific Islander (β = 6.93, p = 0.013) compared to White. While not significant, BP was lower in individuals with higher education compared to those with lower education.

Conclusion: Poorer clinical outcomes were observed in racial and ethnic minorities and individuals with lower education. Targeted strategies for different populations are needed to address disparities in groups that are disproportionately burdened by diabetes.

Disclosure

E.N. San Diego: None. L. Vincent: None. N. Orendain: None. S.R. Spierling Bagsic: None. C. Gordon: None. A. Philis-Tsimikas: Advisory Panel; Dexcom, Inc., Lilly Diabetes, Novo Nordisk, Sanofi, Medtronic, Bayer Inc.

Funding

National Institutes of Health (K12 TR004410); National Institutes of Health (KL2 TR001112)

© 2024 by the American Diabetes Association
2024
Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered. More information is available at http://www.diabetesjournals.org/content/license.