Retrospective Cross-Sectional Study Evaluating Follow-Up Care Visits and Pharmacological Therapy of Individuals with Type II Diabetes and Hypertension in an Urban Community Health Center
Type II diabetes (T2DM) is a chronic illness that affects more than 23.2 million people in the United States, including 750,000 residents in Michigan. Hypertension is a co-morbidity of T2DM. Those with both T2DM and hypertension have increased health risks. African-Americans face health disparities compared to whites and are more likely to have life-threatening illnesses from both diseases. This study used a retrospective analysis of medical records to assess follow-up care visits, including the pharmacological therapy of T2DM and hypertension, in an urban health care center of both white and African-American patients using the American Diabetes Association (ADA) guidelines as a template. The majority of patients did not exhibit glycemic and hypertensive control at the end of the study period (A1c = 8.13% and 77.1% ≥130/≥80, 54.3% ≥140/≥90). Inconsistent with national norms, 58% of African-Americans had A1c levels <7.0% compared to 40% of whites. Forty and 60 percent of whites achieved blood pressure control at the 130/80 and 140/90 cut-off values compared to 13% and 40% of African-Americans, respectively, which was comparable to other studies. Overall, African-Americans attended follow-up visits in a similar frequency to whites according to ADA guidelines. (54% vs. 50%, p=.643). Providers followed the ADA treatment algorithm for T2DM in 55% of visits with A1c measured. Anti-hypertensive medications prescribed fell in line with other studies.