Association of Race and Ethnicity With Glycemic Control and Hemoglobin A<sub>1c</sub> Levels in Youth With Type 1 Diabetes

Kahkoska, Anna R.; Shay, Christina M.; Crandell, Jamie; Dabelea, Dana; Imperatore, Giuseppina; Lawrence, Jean M.; Liese, Angela D.; Pihoker, Cate; Reboussin, Beth A.; Agarwal, Shivani; Tooze, Janet A.; Wagenknecht, Lynne E.; Zhong, Victor; Mayer‐Davis, Elizabeth J.

doi:10.1001/jamanetworkopen.2018.1851

Cited by 83 publications

(57 citation statements)

References 72 publications

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“…Alhough we were able to obtain HbA 1c levels one‐year post‐baseline, the DSSE and Self‐Care Inventory scores were only obtained at baseline, limiting our ability to examine how changes in these factors could have predicted changes in glycaemic control or the direction of these effects. Additionally, factors such as age, race/ethnicity and duration of illness were not significantly associated with self‐care or glycaemic control, contrary to previous research . While the homogeneity and small sample size may have made differences among groups or of moderating effects difficult to detect, the role of race/ethnicity should continue to be examined.…”

Section: Discussioncontrasting

confidence: 64%

“…Furthermore, age and race/ethnicity have been shown to significantly impact overall diabetes care. Adolescence has long been identified as a developmental stage during which glycaemic control and self‐care worsen , but research has shown that ethnic‐minority status significantly increases the probability of poor self‐care and glycaemic control . Increasing knowledge about the relationship between self‐esteem and diabetes management in a high‐risk group has the potential to further increase our understanding of the decline in self‐care and glycaemic control, as well as to inform future research and interventions for providers who work with those adolescents who are struggling to maintain optimal control from a physical and emotional perspective.…”

Section: Introductionmentioning

confidence: 99%

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Diabetes‐specific self‐esteem, self‐care and glycaemic control among adolescents with Type 1 diabetes

et al. 2019

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Aims To explore the relationships between diabetes-specific self-esteem, self-care and glycaemic control among diverse adolescents with Type 1 diabetes.Methods Adolescents (aged 13-21 years) diagnosed with Type 1 diabetes for at least one year, receiving care at an urban medical centre, completed a self-report battery including demographic information, the Diabetes-Specific Self-Esteem Scale and Self-Care Inventory. Glycaemic control (HbA 1c ) was obtained from medical records at recruitment and one year later. Bivariate correlation and multiple linear regression assessed relationships between the Diabetes-Specific Self-Esteem scale, Self-Care Inventory and HbA 1c at baseline and one year.Results Participants included 85 adolescents (15.9 AE 2.1 years; 53% women; 47% Hispanic/Latino). Diabetes-specific self-esteem scores did not differ based on patient characteristics but were significantly correlated with baseline self-care (r = 0.59, P < 0.001) and HbA 1c at baseline (r = -0.51, P < 0.001) and one year later (r = -0.48, P < 0.001). Diabetes-specific self-esteem remained a significant correlate of baseline (b = -0.41, P < 0.001) and follow-up HbA 1c (b = -0.37, P = 0.008) when adjusting for covariates and self-care. Diabetes-specific self-esteem was not significantly associated with change in HbA 1c .Conclusions Results suggest that diabetes-specific self-esteem is significantly associated with self-care and glycaemic control among diverse adolescents with Type 1 diabetes. Diabetes-specific self-esteem may be more closely related to HbA 1c than reports of the frequency of self-care behaviours, and could represent a useful tool for clinical and research applications.

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Section: Discussioncontrasting

confidence: 64%

Section: Introductionmentioning

confidence: 99%

Diabetes‐specific self‐esteem, self‐care and glycaemic control among adolescents with Type 1 diabetes

et al. 2019

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“…Race/ethnicity is likely a surrogate for other important unmeasured variables, which might include biopsychosocial factors like genetic risk, provider and family perceptions of treatment intensity, or access to care . Racial/ethnic disparities in insulin pump use, complications, and treatment outcomes have been widely reported in youth with T1D, including recently in the SEARCH for Diabetes in Youth study, and there is a clear need for novel strategies to close this gap.…”

Section: Discussionmentioning

confidence: 99%

Trajectories of hemoglobin A1c and body mass index z‐score over four decades among 2 to 18 year olds with type 1 diabetes

Snell‐Bergeon

2019

Pediatr Diabetes

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Objectives:To determine trajectories of glycemic control and body mass index (BMI) z-score in a large pediatric sample with type 1 diabetes (T1D) over a 38-year period, and to evaluate sex differences and temporal changes in the prevalence of these trajectories. Methods:We conducted a longitudinal, retrospective study of 7002 2 to 18 year olds with T1D followed between 1978 and 2016 at a single center. Group-based modeling was used to identify trajectories for hemoglobin A1c (HbA1c) and BMI zscore. Multinomial logistic regression identified predictors of membership to less favorable glycemic trajectories.Results: Group-based modeling yielded 5 HbA1c trajectories. A total of 86% of the sample fell within 3 trajectories that were largely stable across childhood and adolescence, and 14% fell within 2 trajectories characterized by marked deterioration beginning in pre-adolescence. Girls were more likely to be in the HbA1c trajectory with the highest starting HbA1c and significant deterioration during adolescence, and in the highest two BMI z-score trajectories. Patients with non-white race had the highest odds of belonging to a less favorable HbA1c trajectory. Prevalence of the high stable HbA1c trajectory decreased and prevalence of the low stable HbA1c trajectory increased over the study period.Conclusions: A minority of youth with T1D experienced deterioration of glycemic control during adolescence. Girls were more likely to belong to the worst HbA1c trajectory and to BMI z-score trajectories in the overweight/obese range, which may increase cardiometabolic risk. Addressing racial/ethnic disparities in glycemic control should remain a priority. Advances in T1D management correlated with favorable shifts in HbA1c trajectory prevalence. K E Y W O R D Sbody mass index, diabetes mellitus, type 1, glycated hemoglobin A, health status disparities, models, statistical

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“…By the year 2050, demographic and incidence trends suggest that there will be a three‐to‐seven‐fold increase in the number of Latino youth with T1DM (Imperatore et al, 2012). Compared to White youth, Latino youth with T1DM have higher rates of elevated glycated hemoglobin (A1C) levels (Kahkoska et al, 2018; Petitti et al, 2009; Willi et al, 2015), placing them at greater risk of serious health consequences (Carlsen et al, 2017; Diabetes Control and Complications Trial Research Group, 1994; White et al, 2001). As the number of Latino youth with T1DM grows, so does the need to improve resources and care for Latino families to support self‐management and adaptation to T1DM.…”

Section: Introductionmentioning

confidence: 99%

Perceptions and experiences of living with type 1 diabetes among Latino adolescents and parents with limited English proficiency

Joiner

DeJonckheere

Whittemore

et al. 2020

Research in Nursing & Health

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We explored perceptions and experiences of living with type 1 diabetes mellitus (T1DM) among U.S. Latino adolescents (age 12-19 years) with T1DM and parents with limited English proficiency. We used a qualitative descriptive approach with semi-structured interviews of adolescents together with their parents. Interview data were reviewed, coded, and combined into themes about participant experiences with T1DM. Twenty-four adolescents (mean age: 15.4 years) and 23 parents participated. Analysis resulted in three themes: (a) Understanding and adapting to T1DM (i.e., initial fear and misunderstandings of T1DM; adolescents' reflections on living with a chronic health condition); (b) Coming to terms with social and environmental influences on T1DM self-management (i.e., T1DM as disruptive to school and social activities; dealing with stigma and judgments related to diabetes); and, (c) Integrating T1DM self-management expectations with components of Latino cultures (i.e., orientation toward family well-being; parent concerns about cultural preferences that influence food choices, positive influence of spirituality and religiousness; parental views of their current health care in comparison to that available in their place of birth). Adolescents and their parents reported experiences that are universal to adolescents with T1DM in addition to challenges that are unique to Latinos. Efforts aimed at improving T1DM self-management during adolescence with this population need to be tailored to meet the unique social and cultural contexts and delivered in a culturally and linguistically congruent manner. K E Y W O R D S adolescent, Hispanic Americans, parents, self-care, self-management, type 1 diabetes mellitus | 271 ORCID Kevin L. Joiner

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Association of Race and Ethnicity With Glycemic Control and Hemoglobin A_1c Levels in Youth With Type 1 Diabetes

Cited by 83 publications

References 72 publications

Diabetes‐specific self‐esteem, self‐care and glycaemic control among adolescents with Type 1 diabetes

Diabetes‐specific self‐esteem, self‐care and glycaemic control among adolescents with Type 1 diabetes

Trajectories of hemoglobin A1c and body mass index z‐score over four decades among 2 to 18 year olds with type 1 diabetes

Perceptions and experiences of living with type 1 diabetes among Latino adolescents and parents with limited English proficiency

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Association of Race and Ethnicity With Glycemic Control and Hemoglobin A1c Levels in Youth With Type 1 Diabetes

Cited by 83 publications

References 72 publications

Diabetes‐specific self‐esteem, self‐care and glycaemic control among adolescents with Type 1 diabetes

Diabetes‐specific self‐esteem, self‐care and glycaemic control among adolescents with Type 1 diabetes

Trajectories of hemoglobin A1c and body mass index z‐score over four decades among 2 to 18 year olds with type 1 diabetes

Perceptions and experiences of living with type 1 diabetes among Latino adolescents and parents with limited English proficiency

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Association of Race and Ethnicity With Glycemic Control and Hemoglobin A_1c Levels in Youth With Type 1 Diabetes