The Effects of a Nurse Case Manager and a Community Health Worker Team on Diabetic Control, Emergency Department Visits, and Hospitalizations Among Urban African Americans With Type 2 Diabetes Mellitus

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Abstract
African Americans bear a disproportionate burden from diabetes mellitus (DM) and its complications.1-3 Compared with their nonminority counterparts, African Americans are almost twice as likely to have DM, twice as likely to experience DM-related blindness, 1.5 to 2.5 times more likely to experience lower limb amputations, and 2 to 6 times more likely have kidney disease.4,5 The risk of developing type 2 DM and its complications can be reduced through lifestyle modifications.6,7 However, contributing factors to health disparities are multifactorial in nature and include patient behavior and characteristics (eg, adherence and health literacy), physician behavior (eg, treatment threshold and target), and health care system factors (eg, access to care and continuity of care).8,9

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