Race/ethnicity and measures of glycaemia in the year after diagnosis among youth with type 1 and type 2 diabetes mellitus

Abstract

Aims: To assess associations between race/ethnicity, glycated hemoglobin (HbA1c), and glycemic control among youth with type 1 (T1D) or type 2 diabetes (T2D).

Methods: The study sample was youth<20years old from the SEARCH California Center diagnosed from 2002 to 2009 who remained insured for at least one year. HbA1c at one year was from clinical data; HbA1c at diagnosis was from clinical data (81%) or imputed (19%). Multivariable logistic and linear regression models were used to examine associations between race/ethnicity and poor glycemic control (≥9.5%), HbA1c at one-year, and change in HbA1c.

Results: The study included 1162 Hispanic (52.3%), non-Hispanic White (NHW, 28.4%), African American (15.1%) and Asian/Pacific Islander (4.1%) youth. Among T1D youth (n=789), Hispanics were 1.60 times as likely (95% CI 1.01-2.53) to have poor control at one year compared to NHWs, after adjustments. Among T2D youth (n=373), only African American youth were significantly more likely (OR=4.85; 95% CI 1.49-15.77) to have poor control at one year, after adjustments. HbA1c at one year and change in HbA1c did not differ by race/ethnicity.

Conclusion: Poor glycemic control was evident one year after diagnosis in some minority youth with T1D or T2D in an integrated managed health care setting.

Keywords: Ethnicity; Race; Socioeconomic status; Type 1 diabetes; Type 2 diabetes; Youth.