Journal
JOURNAL OF DIABETES AND ITS COMPLICATIONS
Volume 32, Issue 12, Pages 1085-1090Publisher
ELSEVIER SCIENCE INC
DOI: 10.1016/j.jdiacomp.2018.02.008
Keywords
Frequency of glucose testing; HbA1c; Children; Type 1 diabetes; Racial disparity; Home glucose monitoring
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Funding
- Annual Scientific Sessions of the American Diabetes Association
- Mid-South Transdisciplinary Collaborative Center for Health Disparities Research [U54MD008176]
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Introduction: Black youth with type 1 diabetes (T1D) have higher HbA1c than whites. To understand HbA1c differences, we examined the relationship of psycho-social factors and glucose testing with HbA1c. Methods: Glucose tests per day (BGs/d) and mean blood glucose (MBG) were calculated from meter data of youth self-identified as black (n = 33) or white (n = 53) with T1D. HbA1c, family income, insurance status, concentrated disadvantage (CDI), psychological depression (DSC), mother educational attainment (MEA), and insulin delivery method (IDM) data was were analyzed. Results: Black patients had significantly higher HbA1c, MBG and disadvantage measures compared to whites. BGs/d correlated with HbA1c, MBG, age and CDI. Race (p < 0.0158), age (p < 0.0001) and IDM (p < 0.0036) accounted for 50% of the variability (R2 = 0.5, p < 0.0001) in BGs/d. Regardless of age, black patients had lower BGs/d than whites. MBG (p < 0.0001) and BGs/d (p < 0.0001) accounted for 61% of the variance in HbA1c (p < 0.0001). Conclusions: BGs/d is easily assessed and closely associated with HbA1c racial disparity. BGs/d is intricately linked with greater social disadvantage. Innovative management approaches are needed to overcome obstacles to optimal outcomes. (C) 2018 Published by Elsevier Inc.
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