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Imad M. El-Kebbi, MD; Curtiss B. Cook, MD; David C. Ziemer, MD; Christopher D. Miller, MD; Daniel L. Gallina, MD; Lawrence S. Phillips, MD

Arch Intern Med. 2003;163:69-75.

Background  Type 2 diabetes mellitus is highly prevalent in minority populations in the United States. We studied the relationship of age to glycemic control in a predominantly urban African American population with type 2 diabetes.

Methods  We selected all patients with type 2 diabetes who were enrolled in the Grady Diabetes Clinic, Atlanta, Ga, between April 1, 1991, and December 31, 1998, and had a hemoglobin A_1c (HbA_1c) level measured at their initial visit and at follow-up 5 to 12 months later (n = 2539). Patients were divided into 4 age categories: less than 30 years, 30 to 49 years, 50 to 69 years, and more than 69 years old. We also studied the relationship of age to HbA_1c level in a primary care clinic.

Results  At baseline, average HbA_1c levels were 9.9%, 9.5%, 9.2%, and 8.8% in the 4 groups ranked in increasing age, respectively (P<.001), and body mass indexes (calculated as weight in kilograms divided by the square of height in meters) were 37.8, 33.9, 31.6, and 29.2, respectively (P<.001). On follow-up, HbA_1c level improved in all groups (P<.001), but there was still a trend for younger patients to have higher levels of HbA_1c. There was little change in body mass index with time. Younger age, longer diabetes duration, higher body mass index, less frequent interval visits, and treatment with oral agents or insulin were associated with a higher HbA_1c level at follow-up. Our findings in a primary care clinic showed also that HbA_1c level and body mass index were negatively correlated with age (P<.001).

Conclusion  Our data show a high prevalence of obesity and poor glycemic control in young adult urban African Americans with diabetes.

From the Division of Endocrinology and Metabolism, Department of Medicine, Emory University School of Medicine, Atlanta, Ga.

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