Uncovering Disparities in Diabetes Prevention Referrals

Uncovering Disparities in Diabetes Prevention Referrals

The National Diabetes Prevention Program (DPP) has been found to help prevent or delay progression to type 2 diabetes (T2D) among people at high-risk for developing the disease. However, these lifestyle-change programs have struggled to reach Black and Hispanic men, who have significantly more complications and higher death rates from T2D compared with women or men from other races and ethnicities.

In a study published online on September 21 in Preventing Chronic Disease, Cara S. Stephenson-Hunter, Ph.D., and colleagues examined DPP referrals for 26,727 Montefiore Health Center patients; 66% were female, 46% were Hispanic, and 39% were non-Hispanic Black. They had no prior diagnosis of T2D and were eligible for referral to the DPP because their electronic health records indicated an elevated risk for developing T2D: hemoglobin A1c levels between 5.7 percent and 6.4 percent and/or a body mass index (BMI) of 25.0 kg/m2 or higher (23.0 kg/m2 if Asian).

The study found that only 10% of these referral-eligible patients were referred to the DPP. Men, non-Hispanic Whites, and uninsured patients were less likely to be referred to the DPP compared with their counterparts. Patients more likely to be referred to the DPP included those with higher levels of hemoglobin A1C and BMI and those seen by family physicians. The findings identify potential inequities in accessing preventive health programs and emphasize the need for interventions to address bias in referrals to the DPP.

Dr. Stephenson-Hunter is an assistant professor of family and social medicine and K12 scholar through the National Institutes of Health-supported Harold and Muriel Block Institute for Clinical and Translational Research at Einstein and Montefiore.

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