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Background.

Black Americans with diabetes have a higher burden of illness and mortality than do white Americans. However, the extent to which differences in medical care processes and treatment intensity contribute to poorer diabetes outcomes is unknown.

Objective.

To assess racial disparities in the quality of diabetes care processes, intermediate outcomes, and treatment intensity.

Methods.

We conducted an observational study of 801 white and 115 black patients who completed the Diabetes Quality Improvement Project survey (response rate= 72%) in 21 Veterans Affairs (VA) facilities using survey data; medical record information on receipt of diabetes services (A1c, low-density lipoprotein [LDL], nephropathy screen, and foot and dilated eye examinations), and intermediate outcomes (glucose control measured by A1c; cholesterol control measured by LDL; and achieved level of blood pressure); and pharmacy …