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Fig. 5. Prevalence counts and adjusted rates, by ethnicity. December 31 point-prevalent end-stage renal disease patients. Rates adjusted for age and gender. For Hispanic patients, we present data beginning in 1996, the first full year after the April 1995 introduction of the revised Medical Evidence form, which contains more specific questions on race and ethnicity. The data reported here have been supplied by the US Renal Data System. The interpretation and reporting of these data are the responsibility of the author(s) and in no way should be seen as an official policy or interpretation of the US government (8).

In the study of US veterans (32), diabetic ESRD was 1.9 times more likely to be present in African Americans than whites. The USRDS reported that in 1996, DN surpassed hypertension as the most common cause of ESRD among African Americans (8). In the United Kingdom, Afro-Caribbeans have a relative risk of diabetic ESRD that is 1.76 times that of whites of (9,33).

The term "Hispanic" refers to Spanish-speaking people in the United States and includes Mexican Americans, Puerto Rican Americans, and Cuban Americans, as well as other immigrants from Latin America and their descendants. The risk of DN among Hispanics in the United States varies with the prevalence of T2DM; Mexican Americans and Puerto Rican Americans have much higher prevalence of T2DM than Cuban Americans (34). Mexican Americans with T2DM are more likely to have diabetic complications than are diabetic non-Hispanic whites of a similar age (35) and Hispanics are more likely to have microalbumiuria (but not macroalbuminuria) than African-Americans or Asians (31). Outside the United States, Latin Americans also have high rates of DN. Of 304 Mexican patients with T2DM from the Mexico City, 84.4% of men and 63.8% of women had microalbuminuria (36). Almost nothing is known about the frequency of early DN in Latin America.

The USRDS began to collect data on Hispanic patients in 1995 and found that Hispanics are disproportionately represented among patients with diabetic ESRD (8). However, the USRDS distinguishes only between Mexican-Americans and non-Mexican Hispanic. Thus, incidence and prevalence of ESRD is known only for Hispanics as a whole and for Mexican Americans. Nevertheless, the USRDS data suggest that incidence rates of ESRD for Hispanics are 1.5 times those of non-Hispanic whites

Elevated protein excretion is present in 33% of Native Americans with diabetes, of whom 10% have microalbuminuria and 23% have overt proteinuria (37). A longitudinal study of Pima Indians found that the incidence rate of proteinuria is increasing despite

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Supplements For Diabetics

Supplements For Diabetics

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