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. 2021 Mar;22(2):241-248.
doi: 10.1111/pedi.13139. Epub 2020 Oct 25.

Racial disparities in treatment and outcomes of children with type 1 diabetes

Terri H Lipman  1   2   3 , Jennifer A Smith  2 , Oona Patil  2 , Steven M Willi  2   3 , Colin P Hawkes  2   3
Affiliations

Racial disparities in treatment and outcomes of children with type 1 diabetes

Terri H Lipman et al. Pediatr Diabetes. 2021 Mar.

Abstract

Objective: The aim of this study was to assess racial disparities in treatments and outcomes between Non-Hispanic black (NHB), Hispanic and Non-Hispanic white (NHW) children with type 1 diabetes (T1D).

Methods: We reviewed electronic health records of children (<18 years) attending a large, pediatric tertiary care diabetes center in the United States between October 1, 2018, and December 31, 2019. Health care utilization (appointment attendance, ED visits, hospitalizations), technology use (insulin pumps, continuous glucose monitors [CGM]) and hemoglobin A1c (HbA1c) were examined for each race/ethnicity and stratified by insurance type (private/government) as a proxy for socioeconomic status (SES).

Results: Of 1331 children (47% female) with a median (IQR) age of 14.2 (11.5, 16.3) years and T1D duration of 5.8 (3.8, 9) years; 1026 (77%) were NHW, 198 (15%) NHB, and 107 (8%) Hispanic. Government insurance was used by 358 (27%) children, representing 60% of NHB and 53% of Hispanic, but only 18% of NHW children. NHB children had higher HbA1c, more ED visits and hospitalizations, and were less likely to be treated with insulin pumps or CGM than NHW children (P < .001 for all). There were no racial disparities with regard to the number of appointments attended.

Conclusions: Racial disparities in technology use and diabetes outcomes persist in children with T1D, regardless of insurance status. To ensure equitable care, pediatric healthcare providers should remain cognizant of racial disparities in diabetes treatment. The impact of provider and patient factors should be explored when studying the etiology of these health disparities.

Keywords: diabetes; disparities; healthcare utilization; hemoglobin A1c; pediatric; race.

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References

REFERENCES

    1. Center for Disease Control and Prevention. National diabetes statistics report. 2014; https://www.cdc.gov/diabetes/data/statistics/statistics-report. Accessed March 30, 2020.
    1. Wild S, Roglic G, Green A, Sicree R, King H. Global prevalence of diabetes: estimates for the year 2000 and projections for 2030. Diabetes Care. 2004;27(5):1047‐1053.
    1. Lipman TH, Ratcliffe SJ, Cooper R, Levitt Katz LE. Population‐based survey of the prevalence of type 1 and type 2 diabetes in school children in Philadelphia. J Diabetes. 2013;5(4):456‐461.
    1. Lipman TH, Levitt Katz LE, Ratcliffe SJ, et al. Increasing incidence of type 1 diabetes in youth: twenty years of the Philadelphia pediatric diabetes registry. Diabetes Care. 2013;36(6):1597‐1603.
    1. Mayer‐Davis EJ, Lawrence JM, Dabelea D, et al. Incidence trends of type 1 and type 2 diabetes among youths, 2002‐2012. N Engl J Med. 2017;376(15):1419‐1429.

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