Journal Article Epublish
PubMed: 40129449 DOI: 10.1089/heq.2023.0186
Racial and Ethnic Disparities in Diabetes Prevention Outcomes: Insights from the Prediabetes Informed Decisions and Education Study.
Health Equity 8(1):659-666
Authors: Yelba Castellon-Lopez, O Kenrik Duru, Norman Turk, Gerardo Moreno, Keith C Norris, Amanda Vu, Rintu P Saju, Chi-Hong Tseng, Kia Skrine-Jeffers, Carol M Mangione, Dominick Frosch, Tannaz Moin
Affiliations
- Department of Biomedical Sciences, Cedars-Sinai Medical Center, Cancer Research Center for Health Equity, Samuel Oschin Comprehensive Cancer Institute, Los Angeles, California, USA.
- David Geffen School of Medicine, University of California, Los Angeles, California, USA.
- Department of Medicine, Division of General Internal Medicine-Health Services Research, University of California, Los Angeles, California, USA.
- David Geffen School of Medicine, University of California, Los Angeles, California, USA. Department of Medicine, Division of General Internal Medicine-Health Services Research, University of California, Los Angeles, California, USA.
- UCLA School of Nursing, Los Angeles, California, USA.
- Jonathan and Karin Fielding School of Public Health, University of California, Los Angeles, California, USA.
- Patient Centered Outcomes Research Institute, Washington, DC, USA.
- HSR&D Center for the Study of Healthcare Innovation, Implementation, and Policy, Veterans Affairs Greater Los Angeles Health System, Los Angeles, California, USA.
Abstract
Background
To achieve health equity, interventions should yield similar effectiveness across all patient subgroups. However, the adoption of diabetes prevention strategies and successful weight loss in "real-world" Diabetes Prevention Program (DPP) translational studies have varied by race and ethnicity. We examined racial and ethnic differences in diabetes prevention outcomes among study participants from the Prediabetes Informed Decisions and Education (PRIDE) Study.
Methods
In a retrospective analysis of data from the PRIDE cluster randomized trial across a large health system, we examined (1) percent weight change and (2) uptake of DPP and/or metformin among overweight/obese participants with prediabetes 12 months after participating in a pharmacist-led shared decision-making (SDM) intervention. We stratified the outcomes by race and ethnicity using a generalized linear mixed-effects model.
Results
The study participants ( = 515) had an average age of 56 years (standard deviation [SD] = 11.0), hemoglobin A1c of 6.0% (SD = 0.20), and body mass index of 30.3 (SD = 5.2). Black/African American and Latino study participants lost significantly less weight at the 12-month follow-up compared with White/Caucasian participants (-1.0% and -1.2%, respectively, vs. -3.3%, < 0.01 for both comparisons). There was no significant difference in the adoption of diabetes prevention strategies between racial and ethnic groups after completing an educational SDM intervention.
Conclusion
To better promote health equity, future studies should investigate the potential causal factors for these differences in weight loss, such as variations in socioeconomic status, physical activity, cultural influences, and neighborhood characteristics.
MeSH
Diabetes Mellitus, Decision Making, Shared, Prediabetic State, Weight Loss, Education