Racial/Ethnic Differences in Glycemic Control in Older Adults with Type 2 Diabetes: United States 2003-2014

Int J Environ Res Public Health. 2020 Feb 4;17(3):950. doi: 10.3390/ijerph17030950.


The aim of this study was to determine whether racial differences in HbA1c persist in older adults (≥65 years) living with type 2 diabetes. Data from The National Health and Nutrition Examination Survey (NHANES) 2003-2014 were used to examine the association between HbA1c and older adults (≥65 years) over time. Compared to non-Hispanic Whites, Mexican Americans had the greatest difference in average HbA1c among minority groups, followed by those with unspecified/mixed ethnicities and non-Hispanic Blacks. In the adjusted linear model, racial minorities had a statistically significant relationship with HbA1c. There was no relationship between HbA1c and older age and insulin use. Trends in mean HbA1c over time increased for non-Hispanic Blacks and Mexican Americans and decreased for non-Hispanic Whites. The findings suggest that racial differences in HbA1c persist into older age and compared to non-Hispanic Whites, non-Hispanic Blacks and Mexican Americans are at an increased risk of morbidity, mortality, and disability due to high HbA1c. Furthermore, alternate measures of glycemic control may be needed to screen and manage T2DM in racial minorities.

Keywords: NHANES; diabetes; glycemic control; older adults; race/ethnicity.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Aged
  • Aged, 80 and over
  • Blood Glucose
  • Continental Population Groups
  • Diabetes Mellitus, Type 2 / blood
  • Diabetes Mellitus, Type 2 / ethnology*
  • European Continental Ancestry Group / statistics & numerical data
  • Female
  • Glycated Hemoglobin A / metabolism*
  • Humans
  • Male
  • Mexican Americans / statistics & numerical data
  • Minority Groups
  • Nutrition Surveys
  • United States / epidemiology


  • Blood Glucose
  • Glycated Hemoglobin A
  • hemoglobin A1c protein, human