Racial?Geographic Disparity in Lipid Management in Veterans with Type 2 Diabetes: A 10-Year Retrospective Cohort Study

Racial?Geographic Disparity in Lipid Management in Veterans with Type 2 Diabetes: A 10-Year Retrospective Cohort Study

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AbstractPurpose: The prevalence of diabetes in U.S.veterans (20.5%) is nearly three times that of the general population.

Minority veterans have higher rates of diabetes compared with their counterparts and urban/rural residence is also associated with uncontrolled cholesterol.However, the interplay between urban/rural residence and race/ethnicity on cholesterol control is unclear.Methods: Veterans Health Administration Corporate Data Warehouse and sensory play Centers for Medicare and Medicaid data were used to create unique dataset and perform longitudinal study of veterans with type 2 diabetes from 2006 to 2016.Logistic regression was used to model the association between low-density lipoprotein (LDL) control and the primary exposures (race/ethnicity and location of residence) after adjusting for all measured Oversized Tee covariates, including the interaction between location of residence and race/ethnicity.

Results: There was a significant interaction between race/ethnicity and rural residence.Rural non-Hispanic Black (NHB) veterans had higher odds for LDL >100?mg/dL (odds ratio [OR]=1.70, 95% confidence interval [CI] 1.50?1.

60) and for LDL >70?mg/dL (OR=1.59, 95% CI 1.53?1.64) compared with urban non-Hispanic White (NHW) veterans.

Similarly, compared with urban NHW, urban NHB veterans had higher odds of LDL >100?mg/dL (OR=1.45, 95% CI 1.43?1.47) and LDL >70?mg/dL (OR=1.

36, 95% CI 1.34?1.38).Conclusion: This study highlights health disparities for veterans with type 2 diabetes.

Future research is needed to evaluate interventions for mitigating these disparities in cholesterol management among veterans with diabetes.