Older Blacks, Latinos Struggle With Diabetes Control

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When the researchers looked at factors that contribute to good blood sugar control, the usual indicators -- such as education, income and access to health care -- didn't play a significant role, Heisler said.

One finding was particularly significant, Heisler said. "African-Americans reported that they didn't take their medications as prescribed," she said. "Medication adherence was one of the most important predictors of blood sugar control."

Heisler looks at this as an encouraging finding, because it's something that can be changed. "We have to do a better job with African-Americans to explain medications and why they are important," she said.

Diabetes-related distress was also an important contributor to poor blood sugar control, particularly among Latinos, Heisler said. "Latinos reported much higher levels of distress related to diabetes than whites," she said. "In general, we need to focus more on helping patients self-manage their diabetes."

Yet these factors, while significant, only explain about one-fifth of the disparity between whites and blacks and Latinos, Heisler said. Other factors could include the quality of health care, medication doses and environmental factors and overall stress, she said.

The findings were published in the Sept. 24 issue of the Archives of Internal Medicine.

Dr. Larry Deeb, president for medicine and science at the American Diabetes Association, thinks doctors need to be more aggressive in treating diabetes among blacks and Latinos.

Based on A1C levels, blacks and Latinos are at significantly greater risk than whites for the complications of diabetes, Deeb said. Those complications include blindness, heart attack, kidney failure and foot amputations. "But we don't have good answers as to why these disparities exist," he said.

Deeb said there could be bias among doctors when they treat blacks and Latinos. "Doctors need to know that people of color tend to have a higher A1C," he said. "It has to be explained. But don't try to explain it away with socioeconomics, don't try to explain it away based on self-management stuff.

"Explain it away by asking yourself, as a doctor: 'Is there something I can do to better control diabetes?'" he said.

More information

For more on diabetes, visit the U.S. National Institute of Diabetes and Digestive and Kidney Diseases.