Language and Socioeconomic Status Impact Glycemic Control in Type 2 Diabetes Patients

Strategic Insights -

According to a study by O.K. Duru and colleagues, patients who speak Spanish and have low socioeconomic status are at greater risk of suboptimal glycemic control. The study, published in the Journal of General Internal Medicine, analyzed data from 1,939 patients with Type 2 diabetes and found that primary language and income, but not race, were associated with medication intensification. Despite having increased odds of intensification, low-income patients were less likely to receive medication intensification compared to higher-income patients.

Key Takeaways:

  • The study found that 42.4% of patients were taking intensified regimens at the time of follow-up, but there was no difference in the odds of intensification for English speakers versus Spanish speakers.
  • Patients with incomes above $75,000 had increased odds of intensification, with an odds ratio of 2.22.
  • Low-income patients were less likely to receive medication intensification compared to higher-income patients.
  • Primary language (Spanish vs. English) was not associated with differences in intensification in a managed care setting.
  • Future studies are needed to explain the reduced rate of intensification among low-income patients in managed care.
  • The study used administrative pharmacy data and included covariates such as age, sex, race/ethnicity, education, Charlson score, diabetes duration, baseline A1c, type of diabetes treatment, and health plan.
  • The study was conducted as part of the Translating Research into Action for Diabetes Study (TRIAD), a study of diabetes care in managed care.

Statistics:

  • 1,939 patients with Type 2 diabetes were enrolled in the study.
  • 42.4% of patients were taking intensified regimens at the time of follow-up.
  • Patients with incomes above $75,000 had an odds ratio (OR) of 2.22 for intensification.
  • Low-income patients were less likely to receive medication intensification compared to higher-income patients.
  • The study used 18-month follow-up data.

Sources:

  • Duru, O.K. et al. "Primary Language, Income and the Intensification of Anti-glycemic Medications in Managed Care: the (TRIAD) Study." Journal of General Internal Medicine, 2011;26(5):505-511.
  • Contact information for O.K. Duru and the University of California, David Geffen School Medical, Division General Internal Medicine Health Service Research.
  • Publisher contact information for the Journal of General Internal Medicine: Springer, 233 Spring St., New York, NY 10013, USA.