Relationship between glycemic control, ethnicity and socioeconomic status in Hispanic and white non-Hispanic youths with type 1 diabetes mellitus

Abstract

Objectives: To determine if there is a disparity in glycemic control between Hispanic and white non-Hispanic children and adolescents with type 1 diabetes mellitus (DM) and to delineate the factors associated with glycemic control in these populations.

Study design: This cross-sectional study included 183 youths with type 1 DM (99 white non-Hispanics and 84 Hispanics) and their parents/guardians cared for in a well-defined, private pediatric endocrine diabetes clinic, where the same physician and diabetes educators treat all patients. The youths were invited to participate if they had been diagnosed with diabetes at least 3 months before the study and were < 21 yr of age. Self-report questionnaires and chart reviews were used to assess individual familial and sociodemographic variables.

Outcomes measured: Mean hemoglobin A1c (HbA1c) levels, compliance with home monitoring of blood sugar, level of parental supervision of treatment, and socioeconomic status of Hispanic and white non-Hispanic families in the study.

Results: Hispanic youths with type 1 DM were in poorer metabolic control than their white non-Hispanic counterparts (0.45% difference in HbA1c levels, p = 0.02). Hispanic youths exhibited lower compliance with home monitoring of blood sugar but their parents reported greater supervision of their diabetes treatment. Hispanic families were found to have significantly lower income, rate of health insurance, father's educational attainment, and mother's educational attainment. Lower family socioeconomic status, but not ethnicity or educational attainment of parents, was associated with a significantly higher HbA1c, regardless of ethnicity.

Conclusions: This study suggests that Hispanic youths with type 1 diabetes may be at greater risk for poor glycemic control because of their lower socioeconomic status rather than their ethnicity.