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A1C: Racial and Ethnic Differences

Differences in A1C by race and ethnicity among patients with impaired glucose tolerance in the Diabetes Prevention Program, by W.H. Herman and colleges. Diabetes Care 30: 2453-2457, 2007.

What is the problem and what is known about it so far?

For over twenty years, doctors have used the A1C test to show how well patients are controlling their blood glucose levels. Researchers also use these scores to test both quality of health care and blood glucose control in groups of blacks and Hispanics.

Why did researchers do this particular study?

Since all studies show that blacks and Hispanics have higher A1C (a measure of long-term blood glucose control), the researchers questioned if blacks, Hispanics, and other ethnicities simply always have a higher A1C score, regardless of health factors.

Who was studied?

About 4,000 people over 25 years old with impaired glucose tolerance (a signal that type 2 diabetes may develop later).

How was the study done?

The data used included a wide range of factors known to change A1C levels including sex, age, and weight. Scientists ran several tests to cancel out these factors? effect on the overall A1C score.

What did researchers find?

Even after researchers adjusted them, the average A1C score was different for each race. White adults had the lowest average score, while black adults had the highest.

What are the limitations of the study?

Doctors also use the A1C to predict the likelihood of developing other health problems like heart disease and kidney failure. This study could not show whether these different ethnicities also had a higher number of additional health problems.

What are the implications of the study?

The A1C may not be the best standard for comparing blood glucose control across races and the quality of health care services. On the small scale, doctors and patients should be aware that their A1C score does not solely reflect self-care but needs to be adapted to a person?s race.

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