Risk factor control among Black and White adults with diabetes onset in older adulthood: The Reasons for Geographic and Racial Differences in Stroke (REGARDS) study

Jalal Uddin; Gargya Malla; Andrea L. Cherrington; Sha Zhu; Doyle M. Cummings; Olivio J. Clay; Todd M. Brown; Loretta T. Lee; Ruth W. Kimokoti; Mary Cushman; Monika M. Safford; April P. Carson

doi:10.1016/j.ypmed.2020.106217

Risk factor control among Black and White adults with diabetes onset in older adulthood: The Reasons for Geographic and Racial Differences in Stroke (REGARDS) study

Jalal Uddin, Gargya Malla, Andrea L. Cherrington, Sha Zhu, Doyle M. Cummings, Olivio J. Clay, Todd M. Brown, Loretta T. Lee, Ruth W. Kimokoti, Mary Cushman, Monika M. Safford, April P. Carson

Résultat de recherche: Article › examen par les pairs

Résumé

The objective of this study was to determine whether attainment of clinical and lifestyle targets varied by race and sex among adults with diabetes onset in older adulthood. This study included 1420 black and white adults from the REGARDS study without diabetes at baseline (2003–07) but with diabetes onset at the follow-up exam (2013–16). Attainment of clinical targets (A1c <8%; blood pressure < 140/90 mmHg; and statin use) and lifestyle targets (not smoking; physical activity≥ 4 times/week; and moderate/no alcohol use) was assessed at the follow-up exam. Modified Poisson regression was used to obtain prevalence ratios (PR) for meeting clinical and lifestyle targets stratified by race and sex, separately. The mean age was 71.5 years, 53.6% were female, and 46.1% were black. The majority were aware of their diabetes status (85.7%) and used oral or injectable hypoglycemic medications (64.8%). Overall, 39.4% met all 3 clinical targets and 18.8% met all 3 lifestyle targets. Meeting A1c and blood pressure targets were similar by race and sex. Statin use was more prevalent for men than women among white adults (PR = 1.13; 95% CI = 0.99–1.29) and black adults (PR = 1.23; 95% CI = 1.06–1.43). For lifestyle factors, the non-smoking prevalence was similar by race and sex, while white men were more likely than white women to be physically active. Although the attainment of each clinical and lifestyle target separately was generally high among adults with diabetes onset in older adulthood, race and sex differences were apparent. Comprehensive management of clinical and lifestyle factors in people with diabetes remains suboptimal.

Langue d'origine	English
Numéro d'article	106217
Journal	Preventive Medicine
Volume	139
DOI	https://doi.org/10.1016/j.ypmed.2020.106217
Statut de publication	Published - oct. 2020
Publié à l'externe	Oui

Note bibliographique

Funding Information:
This research project was supported by a cooperative agreement U01 NS041588 co-funded by the National Institute of Neurological Disorders and Stroke (NINDS) and the National Institute on Aging (NIA), National Institutes of Health , Department of Health and Human Services. Additional support was provided by P30DK079626 funded by the National Institute of Diabetes and Digestive and Kidney Diseases and cooperative agreement U01DP006302 funded by the Centers for Disease Control and Prevention (CDC). This study was conducted by the University of Alabama at Birmingham, one of four academic research centers in The Diabetes LEAD (Location, Environmental Attributes, and Disparities) Network, a CDC-funded collaboration dedicated to providing scientific evidence to develop targeted interventions and policies to prevent type 2 diabetes and related health outcomes across the U.S. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NINDS, NIA, CDC or the Department of Health and Human Services.

Funding Information:
MMS, TMB and APC report investigator-initiated research funding from Amgen, Inc. for work unrelated to this manuscript. No other authors declare conflicts of interest.

Publisher Copyright:
© 2020 Elsevier Inc.

ASJC Scopus Subject Areas

Epidemiology
Public Health, Environmental and Occupational Health

PubMed: MeSH publication types

Journal Article
Research Support, N.I.H., Extramural
Research Support, U.S. Gov't, P.H.S.

ODD de l’ONU

Cette action contribue à la réalisation des objectifs de développement durable suivants

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10.1016/j.ypmed.2020.106217

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Uddin, J., Malla, G., Cherrington, A. L., Zhu, S., Cummings, D. M., Clay, O. J., Brown, T. M., Lee, L. T., Kimokoti, R. W., Cushman, M., Safford, M. M., & Carson, A. P. (2020). Risk factor control among Black and White adults with diabetes onset in older adulthood: The Reasons for Geographic and Racial Differences in Stroke (REGARDS) study. Preventive Medicine, 139, Article 106217. https://doi.org/10.1016/j.ypmed.2020.106217

Uddin, J, Malla, G, Cherrington, AL, Zhu, S, Cummings, DM, Clay, OJ, Brown, TM, Lee, LT, Kimokoti, RW, Cushman, M, Safford, MM & Carson, AP 2020, 'Risk factor control among Black and White adults with diabetes onset in older adulthood: The Reasons for Geographic and Racial Differences in Stroke (REGARDS) study', Preventive Medicine, vol. 139, 106217. https://doi.org/10.1016/j.ypmed.2020.106217

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title = "Risk factor control among Black and White adults with diabetes onset in older adulthood: The Reasons for Geographic and Racial Differences in Stroke (REGARDS) study",

abstract = "The objective of this study was to determine whether attainment of clinical and lifestyle targets varied by race and sex among adults with diabetes onset in older adulthood. This study included 1420 black and white adults from the REGARDS study without diabetes at baseline (2003–07) but with diabetes onset at the follow-up exam (2013–16). Attainment of clinical targets (A1c <8%; blood pressure < 140/90 mmHg; and statin use) and lifestyle targets (not smoking; physical activity≥ 4 times/week; and moderate/no alcohol use) was assessed at the follow-up exam. Modified Poisson regression was used to obtain prevalence ratios (PR) for meeting clinical and lifestyle targets stratified by race and sex, separately. The mean age was 71.5 years, 53.6% were female, and 46.1% were black. The majority were aware of their diabetes status (85.7%) and used oral or injectable hypoglycemic medications (64.8%). Overall, 39.4% met all 3 clinical targets and 18.8% met all 3 lifestyle targets. Meeting A1c and blood pressure targets were similar by race and sex. Statin use was more prevalent for men than women among white adults (PR = 1.13; 95% CI = 0.99–1.29) and black adults (PR = 1.23; 95% CI = 1.06–1.43). For lifestyle factors, the non-smoking prevalence was similar by race and sex, while white men were more likely than white women to be physically active. Although the attainment of each clinical and lifestyle target separately was generally high among adults with diabetes onset in older adulthood, race and sex differences were apparent. Comprehensive management of clinical and lifestyle factors in people with diabetes remains suboptimal.",

author = "Jalal Uddin and Gargya Malla and Cherrington, {Andrea L.} and Sha Zhu and Cummings, {Doyle M.} and Clay, {Olivio J.} and Brown, {Todd M.} and Lee, {Loretta T.} and Kimokoti, {Ruth W.} and Mary Cushman and Safford, {Monika M.} and Carson, {April P.}",

note = "Funding Information: This research project was supported by a cooperative agreement U01 NS041588 co-funded by the National Institute of Neurological Disorders and Stroke (NINDS) and the National Institute on Aging (NIA), National Institutes of Health , Department of Health and Human Services. Additional support was provided by P30DK079626 funded by the National Institute of Diabetes and Digestive and Kidney Diseases and cooperative agreement U01DP006302 funded by the Centers for Disease Control and Prevention (CDC). This study was conducted by the University of Alabama at Birmingham, one of four academic research centers in The Diabetes LEAD (Location, Environmental Attributes, and Disparities) Network, a CDC-funded collaboration dedicated to providing scientific evidence to develop targeted interventions and policies to prevent type 2 diabetes and related health outcomes across the U.S. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NINDS, NIA, CDC or the Department of Health and Human Services. Funding Information: MMS, TMB and APC report investigator-initiated research funding from Amgen, Inc. for work unrelated to this manuscript. No other authors declare conflicts of interest. Publisher Copyright: {\textcopyright} 2020 Elsevier Inc.",

year = "2020",

month = oct,

doi = "10.1016/j.ypmed.2020.106217",

language = "English",

volume = "139",

journal = "Preventive Medicine",

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TY - JOUR

T1 - Risk factor control among Black and White adults with diabetes onset in older adulthood

T2 - The Reasons for Geographic and Racial Differences in Stroke (REGARDS) study

AU - Uddin, Jalal

AU - Malla, Gargya

AU - Cherrington, Andrea L.

AU - Zhu, Sha

AU - Cummings, Doyle M.

AU - Clay, Olivio J.

AU - Brown, Todd M.

AU - Lee, Loretta T.

AU - Kimokoti, Ruth W.

AU - Cushman, Mary

AU - Safford, Monika M.

AU - Carson, April P.

N1 - Funding Information: This research project was supported by a cooperative agreement U01 NS041588 co-funded by the National Institute of Neurological Disorders and Stroke (NINDS) and the National Institute on Aging (NIA), National Institutes of Health , Department of Health and Human Services. Additional support was provided by P30DK079626 funded by the National Institute of Diabetes and Digestive and Kidney Diseases and cooperative agreement U01DP006302 funded by the Centers for Disease Control and Prevention (CDC). This study was conducted by the University of Alabama at Birmingham, one of four academic research centers in The Diabetes LEAD (Location, Environmental Attributes, and Disparities) Network, a CDC-funded collaboration dedicated to providing scientific evidence to develop targeted interventions and policies to prevent type 2 diabetes and related health outcomes across the U.S. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NINDS, NIA, CDC or the Department of Health and Human Services. Funding Information: MMS, TMB and APC report investigator-initiated research funding from Amgen, Inc. for work unrelated to this manuscript. No other authors declare conflicts of interest. Publisher Copyright: © 2020 Elsevier Inc.

PY - 2020/10

Y1 - 2020/10

N2 - The objective of this study was to determine whether attainment of clinical and lifestyle targets varied by race and sex among adults with diabetes onset in older adulthood. This study included 1420 black and white adults from the REGARDS study without diabetes at baseline (2003–07) but with diabetes onset at the follow-up exam (2013–16). Attainment of clinical targets (A1c <8%; blood pressure < 140/90 mmHg; and statin use) and lifestyle targets (not smoking; physical activity≥ 4 times/week; and moderate/no alcohol use) was assessed at the follow-up exam. Modified Poisson regression was used to obtain prevalence ratios (PR) for meeting clinical and lifestyle targets stratified by race and sex, separately. The mean age was 71.5 years, 53.6% were female, and 46.1% were black. The majority were aware of their diabetes status (85.7%) and used oral or injectable hypoglycemic medications (64.8%). Overall, 39.4% met all 3 clinical targets and 18.8% met all 3 lifestyle targets. Meeting A1c and blood pressure targets were similar by race and sex. Statin use was more prevalent for men than women among white adults (PR = 1.13; 95% CI = 0.99–1.29) and black adults (PR = 1.23; 95% CI = 1.06–1.43). For lifestyle factors, the non-smoking prevalence was similar by race and sex, while white men were more likely than white women to be physically active. Although the attainment of each clinical and lifestyle target separately was generally high among adults with diabetes onset in older adulthood, race and sex differences were apparent. Comprehensive management of clinical and lifestyle factors in people with diabetes remains suboptimal.

AB - The objective of this study was to determine whether attainment of clinical and lifestyle targets varied by race and sex among adults with diabetes onset in older adulthood. This study included 1420 black and white adults from the REGARDS study without diabetes at baseline (2003–07) but with diabetes onset at the follow-up exam (2013–16). Attainment of clinical targets (A1c <8%; blood pressure < 140/90 mmHg; and statin use) and lifestyle targets (not smoking; physical activity≥ 4 times/week; and moderate/no alcohol use) was assessed at the follow-up exam. Modified Poisson regression was used to obtain prevalence ratios (PR) for meeting clinical and lifestyle targets stratified by race and sex, separately. The mean age was 71.5 years, 53.6% were female, and 46.1% were black. The majority were aware of their diabetes status (85.7%) and used oral or injectable hypoglycemic medications (64.8%). Overall, 39.4% met all 3 clinical targets and 18.8% met all 3 lifestyle targets. Meeting A1c and blood pressure targets were similar by race and sex. Statin use was more prevalent for men than women among white adults (PR = 1.13; 95% CI = 0.99–1.29) and black adults (PR = 1.23; 95% CI = 1.06–1.43). For lifestyle factors, the non-smoking prevalence was similar by race and sex, while white men were more likely than white women to be physically active. Although the attainment of each clinical and lifestyle target separately was generally high among adults with diabetes onset in older adulthood, race and sex differences were apparent. Comprehensive management of clinical and lifestyle factors in people with diabetes remains suboptimal.

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Risk factor control among Black and White adults with diabetes onset in older adulthood: The Reasons for Geographic and Racial Differences in Stroke (REGARDS) study

Résumé

Note bibliographique

ASJC Scopus Subject Areas

PubMed: MeSH publication types

ODD de l’ONU

Accès au document

Autres fichiers et liens

Empreinte numérique

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