Ethnic Differences in Mortality, End-Stage Complications, and Quality of Care Among Diabetic Patients

Lanting, Loes C.; Joung, Inez M.A.; Mackenbach, Johan P.; Lamberts, Steven W.J.; Bootsma, Aart H.

doi:10.2337/diacare.28.9.2280

Cited by 386Health disparities and outcomesDiabetes Management and EducationDiabetes, Cardiovascular Risks, and Lipoproteins

Ethnic Differences in Mortality, End-Stage Complications, and Quality of Care Among Diabetic Patients

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Lanting, Loes C., Joung, Inez M.A., Mackenbach, Johan P., Lamberts, Steven W.J., Bootsma, Aart H.·2005·Diabetes Care

DOI 10.2337/diacare.28.9.2280

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Abstract

OBJECTIVE—To determine the influence of ethnic differences in diabetes care on inequalities in mortality and prevalence of end-stage complications among diabetic patients. The following questions were examined: 1) Are there ethnic differences among diabetic patients in mortality and end-stage complications and 2) are there ethnic differences among diabetic patients in quality of care? RESEARCH DESIGN AND METHODS—A review of the literature on ethnic differences in the prevalence of complications and mortality among diabetic patients and in the quality of diabetes care was performed by systematically searching articles on Medline published from 1987 through October 2004. RESULTS—A total of 51 studies were included, mainly conducted in the U.S. and the U.K. In general, after adjusting for confounders, diabetic patients from ethnic minorities had higher mortality rates and higher risk of diabetes complications. After additional adjustment for risk factors such as smoking, socioeconomic status, income, years of education, and BMI, in most instances ethnic differences disappear. Nevertheless, blacks and Hispanics in the U.S. and Asians in the U.K. have an increased risk of end-stage renal disease, and blacks and Hispanics in the U.S. have an increased risk of retinopathy. Intermediate outcomes of care were worse in blacks, and they were inclined to be worse in Hispanics. Likewise, ethnic differences in quality of care in the U.S. exist: process of care was worse in blacks. CONCLUSIONS—Given the fact that there are ethnic differences in diabetes care and that ethnic differences in some diabetes complications persist after adjustment for risk factors other than diabetes care, it seems the case that ethnic differences in diabetes care contribute to the more adverse disease outcomes of diabetic patients from some ethnic minority groups. Although no generalizations can be made for all ethnic groups in all regions for all kinds of complications, the results do implicate the importance of quality of care in striving for equal health outcomes among ethnic minorities.

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Racial and ethnic differences in diabetes and corresponding complications are clear risk factors for invasive fungal infections.
“Furthermore, racial and ethnic differences in diabetes and corresponding complications have been thoroughly discussed in the literature and are clear risk factors for IFIs [53–55].”
From Race and ethnicity: Risk factors for fungal infections? (2023) · cites this paper as [54]

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Authors: Lanting, L. C., Joung, I. M. A., Mackenbach, J. P., Lamberts, S. W. J., & Bootsma, A. H.
Affiliations: Erasmus MC (NL)
ORCID: Mackenbach, Johan P.
Venue: Diabetes Care
Publisher: American Diabetes Association
Published: 2005-09-01
Volume: 28
Issue: 9
Pages: 2280-2288
ISSN: 0149-5992 (ISSN-L)
1935-5548
DOI: 10.2337/diacare.28.9.2280
OpenAlex: W2130944773
Cited by: 386
References: 72
Citations by year: 2026: 3 · 2025: 14 · 2024: 20 · 2023: 11 · 2022: 15 · 2021: 25 · 2020: 15 · 2019: 27 · 2018: 17 · 2017: 25 · 2016: 20 · 2015: 28 · 2014: 21 · 2013: 18 · 2012: 23
FWCI: 14.91
Type: journal article
Language: en
Open access: bronze
doi.org
Locations: Diabetes Care (publishedVersion)
PubMed (publishedVersion)
EUR Research Repository (Erasmus University Rotterdam) (publishedVersion, other-oa)
EUR Research Repository (Erasmus University Rotterdam) (submittedVersion, other-oa)
RePub (Erasmus University Rotterdam) (submittedVersion, other-oa)
Topics: Social Sciences › Health › Health disparities and outcomes
Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
Keywords: diabetes mellitus, ethnic disparities, racial disparities, mortality, quality of care, end-stage renal disease, diabetic retinopathy, ethnic minorities, health disparities
MeSH terms: Diabetes Mellitus, Ethnicity, Humans, Quality of Health Care, Diabetes Complications

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Ethnic Differences in Mortality, End-Stage Complications, and Quality of Care Among Diabetic Patients

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