• Darcy Saffar, Keoki Williams, Jennifer Elston Lafata, George Divine, and Manel Pladevall.
• Institute on Multicultural Health, Henry Ford Health System, Detroit, MI, USA. darcy.saffar@va.gov
• Am J Manag Care. 2020 Dec 6; 18 (6): 303-11.

ObjectivesTo describe lipid management over time in a cohort of insured patients with diabetes and evaluate differences between African American and white patients.Study DesignAutomated claims data were used to identify a cohort of 11,411 patients with diabetes in 1997 to 1998. Patients were followed through 2007.MethodsRates of hypercholesterolemia testing, treatment, and goal attainment were measured annually. Treatment was determined by a claim for lipid-lowering agents, and goal attainment was defined as a low-density lipoprotein cholesterol (LDL-C) level <100 mg/dL.ResultsDuring the study period, LDL-C testing increased from 48% to 70% among African American patients and from 61% to 77% among white patients. Treatment with lipid-lowering drugs increased from 23% to 56% among African American patients and 33% to 61% among white patients. The proportion at goal increased from 35% to 76% and from 24% to 59% among white and African American patients, respectively. African American patients were less likely to be tested for LDL-C (odds ratio [OR] 0.79; 95% confidence interval [CI] 0.73-0.86), treated with lipidlowering agents (OR 0.72; 95% CI 0.65-0.80), have their medication dosage altered (OR 0.65; 95% CI 0.59-0.73), or attain LDL-C goal (OR 0.59; 95% CI 0.56-0.63) compared with white patients.ConclusionsAlthough rates of LDL-C testing, treatment, and goal attainment improved over time, racial disparities in dyslipidemia management continued to exist. Further studies to determine the causes of differences in management by race are warranted.

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