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Glycemic Control in English- vs Spanish-Speaking Hispanic Patients With Type 2 Diabetes Mellitus
Laura M. Lasater, MD;
Arthur J. Davidson, MD, MSPH;
John F. Steiner, MD, MPH;
Philip S. Mehler, MD
Arch Intern Med. 2001;161:77-82.
Background Hispanic individuals compose the fastest growing minority group in the
United States, yet little is known about how language impacts their health
care. The primary objective of this study was to determine whether the inability
to speak English adversely affected glycemic control in Hispanic patients
with type 2 diabetes mellitus.
Methods This retrospective cohort study selected 183 Hispanic patients with
type 2 diabetes mellitus aged 35 to 70 years from a public health care system;
patients were Spanish-speaking (SS) only, and control patients were English-speaking
(ES) or bilingual. Clinical information was collected via telephone survey,
and data on health care use, diagnosis, and glycosylated hemoglobin A1c (HbA1c) values were obtained from administrative and laboratory
information systems.
Results Values of HbA1c for SS (mean, 9.1%; range, 5.0%-15.3%) and
ES (mean, 9.0%; range, 4.9%-16.2%) patients with diabetes mellitus and the
total number of hospitalizations related and unrelated to diabetes mellitus
did not differ (P = .86). Spanish-speaking patients
had a diagnosis of diabetes mellitus for fewer years than ES patients (8.2
and 11.2 years, respectively; P = .01). Spanish-speaking
patients were less likely to understand their prescriptions; 22% of SS patients
reported no comprehension vs 3% of ES patients (P
= .001). There was a trend toward decreased prevalence of insulin use among
SS patients compared with ES patients (30% vs 42%, respectively; P = .07).
Conclusions Glycemic control in Hispanic patients was not related to their ability
to speak English. This finding may be explained by a high degree of language
concordance between patients and providers.
From the Division of General Internal Medicine, Denver Health, Denver,
Colo (Drs Lasater and Mehler); the Departments of Preventive Medicine and
Biometrics and Family Medicine (Dr Davidson) and the Division of General Internal
Medicine, Department of Medicine (Dr Steiner), University of Colorado Health
Sciences Center, Denver.
Corresponding author and reprints: Laura M. Lasater, MD, Denver Health,
777 Bannock St, Mail Code 0148, Denver, CO 80204 (e-mail: LLasater{at}dhha.org).
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