Racial disparity in A1C independent of mean blood glucose in children with type 1 diabetes
- PMID: 20185743
- PMCID: PMC2858167
- DOI: 10.2337/dc09-1440
Racial disparity in A1C independent of mean blood glucose in children with type 1 diabetes
Abstract
Objective: Mean blood glucose (MBG) and MBG-independent factors both influence A1C levels. Race was related to A1C independent of MBG in adults. The goal of this study was to determine if racial disparity exists in A1C independent of MBG in children with diabetes.
Research design and methods: Participants included 276 children with type 1 diabetes. A1C and MBG were obtained from multiple clinic visits, and a hemoglobin glycation index (HGI) (an assessment of A1C levels independent of MBG) was calculated. A1C and HGI were analyzed controlling for age, diabetes duration, and MBG. RESULTS African Americans had statistically significantly higher A1C (9.1 +/- 0.1) and HGI (0.64 +/- 0.11) than Caucasians (A1C 8.3 +/- 0.1, HGI -0.15 +/- 0.07) independent of covariates.
Conclusions: Because of racial disparity in A1C, which is independent of MBG, we recommend that A1C and MBG be used together to make therapeutic decisions for children with diabetes.
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References
-
- Hempe JM, Gomez R, McCarter RJ, Jr, Chalew SA: High and low hemoglobin glycation phenotypes in type 1 diabetes: a challenge for interpretation of glycemic control. J Diabetes Complications 2002; 16: 313– 320 - PubMed
-
- McCarter RJ, Hempe JM, Gomez R, Chalew SA: Biological variation in HbA1c predicts risk of retinopathy and nephropathy in type 1 diabetes. Diabetes Care 2004; 27: 1259– 1264 - PubMed
-
- McCarter RJ, Hempe JM, Chalew SA: Mean blood glucose and biological variation have greater influence on HbA1c levels than glucose instability: an analysis of data from the Diabetes Control and Complications Trial. Diabetes Care 2006; 29: 352– 355 - PubMed
-
- Kirk JK, Passmore LV, Bell RA, Narayan KM, D'Agostino RB, Jr, Arcury TA, Quandt SA: Disparities in HbA1c levels between Hispanic and non-Hispanic white adults with diabetes: a meta-analysis. Diabetes Care 2008; 31: 240– 246 - PubMed