Objective: Language barriers may be significant contributors to diabetes disparities. We sought to assess the association of English speaking ability with glycemic control among Latinos with diabetes.
Methods: We analyzed 167 Latinos from a cross-sectional survey of adults with type 2 diabetes. The main outcome was HbA1c > or =7.0%. The main predictor was self-reported English speaking ability. Adjusted analyses accounted for age, sex, education, annual income, health insurance status, duration of diabetes, birth in the United States, and years in the United States.
Results: In unadjusted analyses, point estimates for the odds of having a high HbAlc revealed a U-shaped curve with English speaking ability. Those who spoke English very well (OR=2.32, 95% CI, 1.00-5.41) or not at all (OR=4.11, 95% CI 1.35-12.54) had higher odds of having an elevated HbA1c than those who spoke English well, although this was only statistically significant for those who spoke no English. In adjusted analyses, the U-shaped curve persisted with the highest odds among those who spoke English very well (OR=3.20, 95% CI 1.05-9.79) or not at all (OR 4.95, 95% CI 1.29-18.92).
Conclusions: The relationship between English speaking ability and diabetes management is more complex than previously described. Interventions aimed at improving diabetes outcomes may need to be tailored to specific subgroups within the Latino population.