美国糖尿病患病率、管理、政策和结果的健康和种族差异

Clement G Yedjou, Jennifer N Sims, Sylvianne Njiki, Ariane M Chitoh, Manica Joseph, Ashenafi S Cherkos, Paul B Tchounwou
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摘要

糖尿病(DM)是一种严重的慢性代谢紊乱,以高血糖和各种并发症为特征,包括心血管疾病。当空腹血糖(FPG)水平为126 mg/dL (7.0 mmol/L)或更高时诊断为糖尿病。美国人群中糖尿病患病率的显著差异是显而易见的。虽然糖尿病影响13%的普通成年人,但特定群体,包括美洲印第安人/阿拉斯加原住民(14.7%),西班牙裔(12.5%)和非西班牙裔黑人(11.7%),其发病率不成比例地高。相反,非西班牙裔亚洲人(9.2%)和非西班牙裔白人(7.5%)的患病率较低。美国黑人死于糖尿病相关疾病的可能性是白人的两倍。这篇综述文章的总体目标是全面解决美国糖尿病的种族差异,强调不同种族人群的患病率、管理策略和健康结果。为了实现这一目标,我们利用2014年至2023年全国代表性调查、医疗数据库和已发表文献的数据进行了系统回顾和荟萃分析。我们的研究结果强调了糖尿病患病率的显著种族差异,少数民族人群,包括非洲裔美国人、西班牙裔美国人和印第安人,始终表现出比白人更高的发病率。除了患病率之外,差距还延伸到获得保健资源、糖尿病教育和预防措施方面。此外,在少数民族人群中,糖尿病管理面临挑战,包括获得最佳治疗方式、药物依从性和糖尿病自我管理教育。社会经济因素,特别是收入和教育,在很大程度上造成了这些差异。这篇综述文章有助于提供越来越多的证据,指导政策制定者、卫生保健专业人员和研究人员制定有针对性的策略,以实现糖尿病管理和预防中的健康公平。解决这些差异对于在不同种族人群中培养包容和实用的糖尿病治疗方法至关重要。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Health and Racial Disparities in Diabetes Mellitus Prevalence, Management, Policies, and Outcomes in the United States.

Diabetes Mellitus (DM) is a severe and chronic metabolic disorder characterized by hyperglycaemia and various complications, including cardiovascular disease. It is diagnosed when fasting plasma glucose (FPG) level is126 mg/dL (7.0 mmol/L) or higher [1]. Notable differences in DM prevalence are evident among populations in the United States. While DM affects 13% of the general adult population, specific groups, including American Indians/Alaska Natives (14.7%), Hispanics (12.5%), and non-Hispanic Blacks (11.7%), experience disproportionately higher rates. Conversely, lower prevalence rates are observed among non-Hispanic Asians (9.2%) and non-Hispanic Whites (7.5%). Black Americans are twice as likely to succumb to diabetes-related mortality compared to Whites [2]. The overall objective of this review article is to comprehensively address racial disparities in DM within the United States, emphasizing prevalence rates, management strategies, and health outcomes across diverse ethnic groups. To achieve this objective, we conducted a systematic review and meta-analysis utilizing data from nationally representative surveys, healthcare databases, and published literature spanning from 2014 to 2023. Our findings highlight significant racial disparities in DM prevalence, with minority populations, including African Americans, Hispanics, and Native Americans, consistently exhibiting higher rates than their Caucasian counterparts. Beyond prevalence, disparities extend to access to healthcare resources, diabetes education, and preventive measures. Additionally, challenges in DM management, including access to optimal treatment modalities, medication adherence, and diabetes self-management education, are identified among minority populations. Socioeconomic factors, particularly income and education, significantly contribute to these disparities. This review article contributes to the growing body of evidence guiding policymakers, healthcare professionals, and researchers in developing targeted strategies to achieve health equity in diabetes management and prevention. Addressing these disparities is crucial for fostering an inclusive and practical approach to DM care within diverse ethnic populations.

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