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Health status of New Zealand European, Maori, and Pacific patients with diabetes at 242 New Zealand general practices.
N Z Med J. 2006 Jun 02; 119(1235):U2004.NZ

Abstract

OBJECTIVE

To compare the care and health status of different ethnic groups attending general practices with diabetes.

METHOD

We analysed information about 13,281 patients with any type of diabetes, collected by 242 general practices in the first visit of the Southlink Independent Practitioner Association's Get Checked program. These patients constituted about 60% of patients with diabetes in the South Island of New Zealand.

RESULTS

13,196 (99.4%) patients had Type 1 or Type 2 diabetes. Of these, 11,911 (90.3%) were Europeans, and 759 (5.8%) were Maori or Pacific Islanders (mostly of Samoan, Tongan, Niuean, or Cook Islands origin). There was no difference between ethnic groups in total cholesterol, proportions on oral therapy or statins, or having a foot check. Maori and Pacific Islanders had poorer glycaemic control (HbA1c > 8.0 for 41.5% of Maori or Pacific Islanders versus 23.8% of New Zealand Europeans; 95% confidence interval for the difference [CI]: 14.0, 21.1), and were less likely to have retinopathy screening (71.9% versus 77.9%; CI: -9.2, -2.6). In patients with Type 2 diabetes (and compared with Europeans) Maori and Pacific Islanders were younger, had higher mean body mass indices (males 33.9 versus 29.5; CI: 3.9, 5.0 and females - 34.6 versus 30.7; CI: 3.2, 4.6) and diastolic blood pressures 82.4 mmHg versus 78.7 mmHg (CI: 2.9, 4.5), and were more likely to smoke (27.5% versus 10.9%; CI: 13.3, 19.9). Overall, Maori and Pacific Islanders were more likely to be at high risk for microvascular complications (9.0% versus 4.4%; CI: 2.5, 6.6).

CONCLUSIONS

In this study, Maori and Pacific Island patients had a demographic profile suggesting greater health vulnerability (especially for those with Type 2 diabetes) yet similar routine diabetes care (especially for those with Type 1 diabetes). Ethnic inequalities were noted in seven of nine health status measures.

IMPLICATIONS

The Get Checked program aims to increase the health of all patients with diabetes but whether it accentuates or diminishes ethnic disparities is not yet known.

Authors+Show Affiliations

Royal New Zealand College of General Practitioners' Research Unit, Department of General Practice, Dunedin School of Medicine, University of Otago, Dunedin. andrewtomlin@hotmail.comNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

16751827

Citation

Tomlin, Andrew, et al. "Health Status of New Zealand European, Maori, and Pacific Patients With Diabetes at 242 New Zealand General Practices." The New Zealand Medical Journal, vol. 119, no. 1235, 2006, pp. U2004.
Tomlin A, Tilyard M, Dawson A, et al. Health status of New Zealand European, Maori, and Pacific patients with diabetes at 242 New Zealand general practices. N Z Med J. 2006;119(1235):U2004.
Tomlin, A., Tilyard, M., Dawson, A., & Dovey, S. (2006). Health status of New Zealand European, Maori, and Pacific patients with diabetes at 242 New Zealand general practices. The New Zealand Medical Journal, 119(1235), U2004.
Tomlin A, et al. Health Status of New Zealand European, Maori, and Pacific Patients With Diabetes at 242 New Zealand General Practices. N Z Med J. 2006 Jun 2;119(1235):U2004. PubMed PMID: 16751827.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Health status of New Zealand European, Maori, and Pacific patients with diabetes at 242 New Zealand general practices. AU - Tomlin,Andrew, AU - Tilyard,Murray, AU - Dawson,Alexander, AU - Dovey,Susan, Y1 - 2006/06/02/ PY - 2006/6/6/pubmed PY - 2006/6/24/medline PY - 2006/6/6/entrez SP - U2004 EP - U2004 JF - The New Zealand medical journal JO - N Z Med J VL - 119 IS - 1235 N2 - OBJECTIVE: To compare the care and health status of different ethnic groups attending general practices with diabetes. METHOD: We analysed information about 13,281 patients with any type of diabetes, collected by 242 general practices in the first visit of the Southlink Independent Practitioner Association's Get Checked program. These patients constituted about 60% of patients with diabetes in the South Island of New Zealand. RESULTS: 13,196 (99.4%) patients had Type 1 or Type 2 diabetes. Of these, 11,911 (90.3%) were Europeans, and 759 (5.8%) were Maori or Pacific Islanders (mostly of Samoan, Tongan, Niuean, or Cook Islands origin). There was no difference between ethnic groups in total cholesterol, proportions on oral therapy or statins, or having a foot check. Maori and Pacific Islanders had poorer glycaemic control (HbA1c > 8.0 for 41.5% of Maori or Pacific Islanders versus 23.8% of New Zealand Europeans; 95% confidence interval for the difference [CI]: 14.0, 21.1), and were less likely to have retinopathy screening (71.9% versus 77.9%; CI: -9.2, -2.6). In patients with Type 2 diabetes (and compared with Europeans) Maori and Pacific Islanders were younger, had higher mean body mass indices (males 33.9 versus 29.5; CI: 3.9, 5.0 and females - 34.6 versus 30.7; CI: 3.2, 4.6) and diastolic blood pressures 82.4 mmHg versus 78.7 mmHg (CI: 2.9, 4.5), and were more likely to smoke (27.5% versus 10.9%; CI: 13.3, 19.9). Overall, Maori and Pacific Islanders were more likely to be at high risk for microvascular complications (9.0% versus 4.4%; CI: 2.5, 6.6). CONCLUSIONS: In this study, Maori and Pacific Island patients had a demographic profile suggesting greater health vulnerability (especially for those with Type 2 diabetes) yet similar routine diabetes care (especially for those with Type 1 diabetes). Ethnic inequalities were noted in seven of nine health status measures. IMPLICATIONS: The Get Checked program aims to increase the health of all patients with diabetes but whether it accentuates or diminishes ethnic disparities is not yet known. SN - 1175-8716 UR - https://www.unboundmedicine.com/medline/citation/16751827/Health_status_of_New_Zealand_European_Maori_and_Pacific_patients_with_diabetes_at_242_New_Zealand_general_practices_ L2 - http://www.diseaseinfosearch.org/result/2236 DB - PRIME DP - Unbound Medicine ER -