Use of Antihyperglycemic Medications Among US People with Limited English Proficiency

Abstract Background Language barriers can impact pharmaceutical disease management leading to potential health disparities among limited English proficiency (LEP) people with diabetes mellitus (DM) in the United States (US). Objective To assess the use of antihyperglycemic medications and estimate their impact on glycemic control by LEP status. Design Cross-sectional design. We compared the classes of prescribed antihyperglycemic medications and their impact on glycemic control between English-speaking and LEP participants (i.e., Spanish-speaking or needing interpretation services) with DM applying generalized linear models and adjusting for sociodemographic variables. Participants Data from the US National Health and Nutrition Examination Survey (NHANES 2003–2018). Main Measures Selected language for interview or interpreter request (main exposure). Outcomes include prescribed antihyperglycemic medications and glycemic control (HBA1c). Key Results Data for 4666 participants with DM were analyzed. Antihyperglycemic medications were similarly used by LEP and English-speaking people with DM, except for insulin, which was less frequently used by LEP people. Despite similar medications, LEP people using biguanides and TZDs were less likely to reach glycemic target levels (adjusted odds ratios ranging 1.7 to 3.3) compared to English-speaking people with DM. Conclusions Our findings indicate that the differences in DM outcomes among LEP people are likely attributed to factors other than medication prescription. These might include cultural beliefs, dietary adjustments, and communication barriers in healthcare. Enhanced patient education, acknowledgment of cultural practices, and improved language services could potentially mitigate these disparities.