1352-P: Ethnic Disparities in Diabetic Complications in the U.S.

Objective: To estimate the prevalence of diabetes (DM) complications and assess risk factors for complications by ethnicity and DM duration.

Methods: We used National Health and Nutrition Examination Survey data, 1999-2018. We defined cardiovascular disease (CVD) as a history of heart failure, stroke, or heart attack; chronic kidney disease (CKD) as an eGFR <60, albuminuria, or both; retinopathy as retinal microaneurysms or blot hemorrhages; and lower extremity disease (LED) as peripheral neuropathy, peripheral artery disease, or ulcers. We assessed the age-adjusted prevalence of each complication and multivariable logistic regressions for risk factors related to any complication by ethnicity in new (DM< 10 y without insulin) and established patients (DM≥10 y).

Results: Non-Hispanic Whites (W) had the highest CVD rates, followed by Blacks (B), Mexican Americans (M), and Asian Americans (A) in both new (31% W, 21% B, 14% M, 11% A) and established patients (38% W, 36% B, 29% M, 28% A). Blacks had the highest CKD rates in both new (40% B, 33% W, 31% A, 30% M) and established patients (63% B, 52% M, 51% W, 40% A). For retinopathy, in new patients, Mexican Americans had the highest rate (27% M, 20% B, 12% W), while in established patients, Whites had the most (62% W, 61% B, 57% M). Blacks had the highest rates for LED in both new (52% B, 47% W, 45% M) and established patients (78% B, 68% W, 59% M). Male gender was a risk factor for any DM complication in Asian Americans (new patients, odds ratio 3.9, 95% CI 2-7.5; established, 2.5, 1.1-5.4). Obesity was a risk factor in Black new patients (1.4, 1-1.8). Poor glycemic control was a risk factor in Asian American (4, 2.2-7.6) and White new patients (1.5, 1.1-2.1), and Black established patients (1.7, 1.2-2.4).

Conclusions: White patients had the highest rate of CVD, while Blacks had the most CKD and LED. Mexican Americans with < 10 y of DM had more retinopathy than their ethnic counterparts. Interventions to integrate the male sex and promote weight and glycemic control may reduce DM complications in ethnic minorities.