May 10, 2010

Diabetes Care in a Predominantly Native Hawaiian and Pacific Islander Outpatient Population

Rachel Lee M.D.; Janet Onopa M.D.; Marjorie K. Mau M.D.; and Todd B. Seto M.D., M.P.H.

Hawai‘i Medical Journal

Purpose: Racial differences in diabetes care and outcomes, particularly among African Americans and Hispanics, have been well recognized. The goal of this study was to evaluate the quality of diabetes care, using nationally recognized standards of care, in a multispecialty, hospital-based clinic that cares for a predominantly Native Hawaiian and Pacific Islander population.

Methods: We identified patients with a new primary or secondary diagnosis of diabetes during a visit (baseline visit) between January 2005 and June 2006 at the Queen Emma Clinics. Each patient’s medical record was reviewed to obtain demographic and clinical information related to diabetes, including laboratory and test results and medications, from the baseline visit through 12 months follow-up. Performance indicators were selected from those recommended by the National Diabetes Quality Improvement Alliance and included selected 8 measures: 1) Hemoglobin A1c ≥ 9.0%; 2) Annual lipid panel checked; 3) Systolic blood pressure 9%, annual fundoscopic examination).

Conclusions: Native Hawaiians and Pacific Islanders with diabetes have poorer blood glucose control compared with Caucasians and Asians, but the overall care is otherwise generally similar. The diabetes care received by patients in this clinic that treats a generally underserved population compares favorably with national benchmarks.

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