Stuart Chalew1, Ricardo Gomez2, Alfonso Vargas2, Jodi Kamps3, Brittney Jurgen3, Richard Scribner4, James Hempe5. 1. Division of Endocrinology and Diabetes, Children's Hospital of New Orleans and The Louisiana State University Health Sciences Center, 200 Henry Clay Ave, New Orleans, LA 70118, USA. Electronic address: schale@lsuhsc.edu. 2. Division of Endocrinology and Diabetes, Children's Hospital of New Orleans and The Louisiana State University Health Sciences Center, 200 Henry Clay Ave, New Orleans, LA 70118, USA. 3. Department of Psychology, Children's Hospital of New Orleans, 200 Henry Clay Ave, New Orleans, LA 70118, USA. 4. School of Public Health, The Louisiana State University Health Sciences Center, 433 Bolivar St, New Orleans, LA 70112, USA. 5. Research Institute for Children, Children's Hospital of New Orleans and The Louisiana State University Health Sciences Center, 200 Henry Clay Ave, New Orleans, LA 70118, USA.
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.
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.
Authors: Rebecca Ortiz La Banca; Yasaman Pirahanchi; Lisa K Volkening; Zijing Guo; Julia Cartaya; Lori M Laffel Journal: Prim Care Diabetes Date: 2021-05-21 Impact factor: 2.567