Objective: To examine trends in diabetes management, by race and sex, in the southeast United States.
Design: Population-based survey.
Setting: Southeast United States (ie, Alabama, Florida, Georgia, Kentucky, Mississippi, North Carolina, South Carolina, and Tennessee).
Participants: Whites and Blacks surveyed through the Centers for Disease Control and Prevention Behavioral Risk Factor Surveillance System between 2000 and 2007 in the southeast United States.
Main outcome measures: Total diabetes management included personal factors (checking blood glucose and feet), healthcare provider factors (visiting a doctor, checking hemoglobin A1c, checking feet) and vaccinations (influenza, pneumonia).
Results: Vaccination levels were low throughout the study period, and a racial disparity in vaccination rates developed because trends in prevalence increased more rapidly in Whites relative to Blacks. Personal diabetes management increased significantly in all race/sex groups with greater increases in Black than White men, resulting in White men having lower point estimates of prevalence than Black men. Healthcare provider diabetes management increased significantly in all race/sex groups with the exception of Black men. Considering vaccinations together with personal and provider diabetes management criteria, diabetes management improved significantly in all race/sex groups, but remained low in 2007 (ie, 8.8%, Black women; 14.0%, White women; 11.5%, Black men; 12.8% White men).
Conclusion: Emphasis should be placed on improving vaccination levels, diabetes patient self-management and provider-management in the southeast United States. Although diabetes management improved over the study time period, in 2007 the percent of individuals meeting all of the diabetes management criteria examined remained very low ranging from 8.8% in Black women to 14.0% in White women.