Hemoglobin A1c, frequency of glucose testing and social disadvantage: Metrics of racial health disparity in youth with type 1 diabetes
- PMID: 30318164
- DOI: 10.1016/j.jdiacomp.2018.02.008
Hemoglobin A1c, frequency of glucose testing and social disadvantage: Metrics of racial health disparity in youth with type 1 diabetes
Abstract
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.
Keywords: Children; Frequency of glucose testing; HbA1c; Home glucose monitoring; Racial disparity; Type 1 diabetes.
Copyright © 2018. Published by Elsevier Inc.
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