糖尿病眼科医療における格差~マイノリティは検査回数が少なく病気になる割合が高い(Disparities in Diabetic Eye Care~Minorities Have Fewer Exams, Higher Rates of Illness)

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2022-03-30 ヒューストン大学(UH)

米国では、糖尿病は働き盛りの高齢者が新たに失明する原因の第一位であるため、医療専門家は糖尿病と診断されたら、拡張眼検査を受けるよう患者さんに勧めています。米国眼科学会、米国検眼士協会、米国糖尿病協会によるこの適切なアドバイスにもかかわらず、糖尿病患者の約48%しか定期的な検査を受けていません。Diabetes Epidemiology and Management誌に掲載されたヒューストン大学の新しい研究は、眼科検診を受ける人の数と糖尿病性眼合併症の有病率につながる著しい人種・民族的格差を説明する可能性があります。

<関連情報>

人種・民族的マイノリティにおける糖尿病眼合併症の格差。2009-2018年米国医療費パネル調査の分析 Disparity in diabetic eye complications among racial/ethnic minorities: An Analysis of the 2009-2018 United States Medical Expenditure Panel Survey

Jieni Li,Wendy Harrison,Sang Kyu Cho
Diabetes Epidemiology and Managemen Published:2022-03-11
https://doi.org/10.1016/j.deman.2022.100070

Figure 1

Abstract

Aims

: To evaluate the prevalence and risk factors of diabetic eye complications among the United States (US) adults across racial and ethnic groups.

Methods

: Using the 2009-2018 Medical Expenditures Panel Survey (MEPS) data, this study included adults with diabetes conditions. Patients were grouped into African Americans, Hispanics, and Whites based on self-reported identity. The rate of diabetic eye complications was reported and compared across racial/ethnic groups. This study applied multivariable logistic regression models to examine dilated eye exam attendance, and the completion of American Diabetes Association (ADA) recommended guidelines for diabetes care across racial/ethnic groups.

Results

: This study identified 8,080 patients with diabetic eye complications, which represented a national estimation of 4.12 million US adults according to MEPS data. Among diabetic patients, Hispanics (18.78%) and African Americans (18.18%) had higher rates of eye complications than Whites (12.71%). After adjusting relevant demographic, socioeconomic, and clinical variables, the multivariable model found that Hispanics and African Americans had 1.63 and 1.61 times more likely to have diabetic eye complications compared to Whites. In addition, African Americans were 29% less likely to complete all of the ADA-recommended processes of diabetes care than White patients.

Conclusions

: Compared to White patients, Hispanics and African Americans had a higher rate of diabetic eye complications and were less likely to manage diabetes appropriately. Healthcare providers and policymakers should promote interventions and education programs accordingly to prevent and reduce the development of eye complications among minorities.

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