Primary Language, Income and the Intensification of Anti-Glycemic Medications in Managed Care

This article examines how language and income interact with treatment of Type II diabetes in a large managed-care trial. Previous research has shown that minorities and low-socioeconomic status individuals have more poorly controlled blood sugar levels than White Americans, and Spanish-speaking individuals are also at high risk for poorly controlled blood sugar levels.

The authors analyzed administrative data from the Translating Research into Action for Diabetes Study (TRIAD), which studies diabetes management in managed care. They conducted a multivariate analysis on information from 1,939 patients with type II diabetes who were not receiving insulin at the beginning of the study.

Key Findings:

  • Forty-two percent of patients were on intensified diabetes management regimens 18 months after the baseline data were collected.
  • There was no significant difference in rates of diabetes management intensification between English and Spanish speakers.
  • Low-income individuals were less likely to have intensified diabetes management than individuals in higher income brackets.

This research indicates that diabetes management in a managed care setting varies by income but not by primary language. Further research may be necessary to understand why lower income patients are less likely to have intensified diabetes management regimens.