Health disparities among youth with type 1 diabetes: A systematic review of the current literature.

Borschuk, Adrienne P.; Everhart, Robin S.

doi:10.1037/fsh0000134

Cited by 91 publications

(75 citation statements)

References 61 publications

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“…Thus, in a previous review on a similar topic, more homogeneous results were found showing that in 18 studies adolescents with a lower socio‐economic status had higher HbA 1c levels than adolescents with a higher socio‐economic status, and in three further studies young people with lower socio‐economic status experienced more acute complications compared with those with higher socio‐economic status. But in this review, the authors did not distinguish between the different indicators of socio‐economic status .…”

Section: Discussionmentioning

confidence: 93%

Inequalities in glycaemic control, hypoglycaemia and diabetic ketoacidosis according to socio‐economic status and area‐level deprivation in Type 1 diabetes mellitus: a systematic review

2017

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Aim The aim of this systematic review was to examine the associations of individual-level as well as area-level socioeconomic status and area-level deprivation with glycaemic control, hypoglycaemia and diabetic ketoacidosis in people with Type 1 diabetes mellitus.Methods Ovid MEDLINE was searched to identify relevant cohort, case-control or cross-sectional studies published between January 2000 and June 2015. Search results were screened by title, abstract and keywords to identify eligible publications. Decisions on inclusion or exclusion of full texts were made independently by two reviewers. The Newcastle-Ottawa Scale was used to estimate the methodological quality of included studies. Quality assessment and extracted data of included studies were synthesized narratively and reported according to the PRISMA statement.Results Literature search in Ovid MEDLINE identified 1345 eligible studies. Twenty studies matched our inclusion and exclusion criteria. Two articles were additionally identified through hand search. According to the Newcastle-Ottawa Scale, most of the studies were of average quality. Results on associations of socio-economic status and area-level deprivation with glycaemic control and hypoglycaemia were contradictory between studies. By contrast, lower socioeconomic status and higher area-level deprivation were associated with a higher risk for diabetic ketoacidosis in all except one study.Conclusions Lower socio-economic status and higher area-level deprivation are associated with a higher risk of experiencing diabetic ketoacidosis in people with Type 1 diabetes mellitus. Access to care for socially deprived people needs to be expanded to overcome impairing effects on the course of the condition and to reduce healthcare disparities.

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Section: Discussionmentioning

confidence: 93%

Inequalities in glycaemic control, hypoglycaemia and diabetic ketoacidosis according to socio‐economic status and area‐level deprivation in Type 1 diabetes mellitus: a systematic review

2017

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“…Notably, we show that causal-biochemical knowledge mediates the negative effect of low family income on glycaemic control. The impact of family-related risk factors on HbA1c levels was shown in several studies; factors such as single-parent family, low socioeconomic status, non-Caucasian ethnicity and family conflicts were previously found to be correlated with poor glycaemic control and high serum levels of HbA1c (Borschuk & Everhart, 2015;Gomes & Negrato, 2016;Lewin et al, 2006;Mazarello Paes et al, 2018;Stahl-Pehe et al, 2017). Although low family income was significantly associated with high HbA1c levels in our bivariate analyses and in the hierarchical model, when analysed by the mediation model, causal-biochemical knowledge blurred its significance, whereas T1DM self-management knowledge did not.…”

Section: Discussionmentioning

confidence: 97%

Adherence to diabetes care: Knowledge of biochemical processes has a high impact on glycaemic control among adolescents with type 1 diabetes

Dagan

Dubovi

Levy

et al. 2019

Journal of Advanced Nursing

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Aim To evaluate the impact of patients’ understanding of biochemical processes involved in glucose regulation (causal‐biochemical knowledge) and of diabetes self‐management knowledge on adherence to treatment recommendations among adolescents with type 1 diabetes mellitus. Design A cross‐sectional study. Methods Adolescents with type 1 diabetes mellitus, aged 12–18 years and able to read and write in Hebrew or in Arabic were eligible. Participants were recruited between August 2016 – January 2018 during routine visits to the Paediatric Diabetes Clinic; informed consent was obtained as customary. Patients completed sociodemographic, clinical and type 1 diabetes mellitus self‐management and biochemical knowledge questionnaires. Adherence to treatment was assessed by patients’ serum HbA1c levels, collected from medical records. Results Ninety‐seven patients participated in the study. Mean HbA1c levels were 9.2% (1.9%) and only 24 (24.7%) patients met the recommended HbA1c ≤ 7.5%. Lower HbA1c levels were strongly associated with higher family income, older age at diagnosis and with better type 1 diabetes mellitus self‐management and causal‐biochemical knowledge. A regression model showed that causal‐biochemical knowledge contributed to the variance in HbA1c levels. Furthermore, causal‐biochemical knowledge, but not self‐management knowledge, was found to mediate the negative relationship between low family income and high HbA1c levels. Conclusions Causal‐biochemical knowledge is a valuable component for the adherence to diabetes care and glycaemic control. Impact Our study suggests that causal knowledge is a valuable component that should be included in nursing and healthcare educational programmes for adolescents with type 1 diabetes mellitus.

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“…18 Meanwhile, lower socioeconomic status has been associated with higher post-discharge mortality among elderly patients. 19 While social determinants such as education, race, and income have been associated with disease development and outcomes, [19][20][21][22] they are also intricately associated with each other as well as additional social determinants, health behaviors, and medical comorbidities. [23][24][25] Thus, the causality of a single social determinant on disease outcome is difficult to identify but rather several social determinants often work together to influence disease development.…”

Section: Discussionmentioning

confidence: 99%

The impact of social determinants of health on laryngotracheal stenosis development and outcomes

et al. 2019

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Objectives The social determinants of health affect a wide range of health outcomes and risks. To date, there have been no studies evaluating the impact of social determinants of health on laryngotracheal stenosis (LTS). We sought to describe the social determinants in a cohort of LTS patients and explore their association with treatment outcome. Methods Subjects diagnosed with LTS undergoing surgical procedures between 2013 and 2018 were identified. Matched controls were identified from intensive care unit (ICU) patients who underwent intubation for greater than 24 hours. Medical comorbidities, stenosis characteristics, and patient demographics were abstracted from the clinical record. Tracheostomy at last follow‐up was recorded from the medical record and phone calls. Socioeconomic data was obtained from the American Community Survey. Results One hundred twenty‐two cases met inclusion criteria. Cases had significantly lower education compared to Tennessee (P = .009) but similar education rates as ICU controls. Cases had significantly higher body mass index (odds ratio [OR]: 1.04, P = .035), duration of intubation (OR: 1.21, P < .001), and tobacco use (OR: 1.21, P = .006) in adjusted analysis when compared to controls. Tracheostomy dependence within the case cohort was significantly associated with public insurance (OR: 1.33, P = .016) and chronic obstructive pulmonary disease (OR: 1.34, P = .018) in adjusted analysis. Conclusion Intubation practices, medical comorbidities and social determinants of health may influence the development of LTS and tracheostomy dependence after treatment. Identification of at‐risk populations in ICUs may allow for prevention of tracheostomy dependence through the use of early tracheostomy and specialized follow‐up. Level of Evidence Level 3, retrospective review comparing cases and controls Laryngoscope, 130:1000–1006, 2020

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Health disparities among youth with type 1 diabetes: A systematic review of the current literature.

Cited by 91 publications

References 61 publications

Inequalities in glycaemic control, hypoglycaemia and diabetic ketoacidosis according to socio‐economic status and area‐level deprivation in Type 1 diabetes mellitus: a systematic review

Inequalities in glycaemic control, hypoglycaemia and diabetic ketoacidosis according to socio‐economic status and area‐level deprivation in Type 1 diabetes mellitus: a systematic review

Adherence to diabetes care: Knowledge of biochemical processes has a high impact on glycaemic control among adolescents with type 1 diabetes

The impact of social determinants of health on laryngotracheal stenosis development and outcomes

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