Relationship between glycemic control, ethnicity and socioeconomic status in Hispanic and white non-Hispanic youths with type 1 diabetes mellitus

Abstract

This study suggests that Hispanic youths with type 1 diabetes may be at greater risk for poor glycemic control because of their lower socioeconomic status rather than their ethnicity.

Ethnicity and social deprivation independently influence metabolic control in children with type 1 diabetes

“…Ethnicity had a greater impact than SES on HbA 1c , and moderate to severe hypoglycaemia was more prevalent in minority ethnic groups and was not associated with SES. These findings are consistent with previous reports that children from ethnic minorities have higher HbA 1c levels in both the USA [2,13,30] and Europe [15,16]. However these differences have often been ascribed to differences in SES [2,18].…”

“…These findings are consistent with previous reports that children from ethnic minorities have higher HbA 1c levels in both the USA [2,13,30] and Europe [15,16]. However these differences have often been ascribed to differences in SES [2,18]. In contrast, the present analysis strongly suggests that, although part of the effect is related to higher levels of deprivation, ethnicity makes a substantial direct contribution.…”

“…Determining the relative contribution of cultural influences on health vs the fundamental fiscal ability to access and use necessary healthcare has proved difficult. Several studies from the USA [2][3][4] and UK [5] have indicated that SES and affluence, rather than ethnicity, primarily mediate the effect on health outcomes. Evidence from New Zealand suggests that inequalities in health persist even after adjusting for deprivation [6]; likely due to multiple factors, including differences in health-risk behaviours such as smoking rates [7] and institutional or interpersonal discrimination [6].…”

“…Cross-sectional studies typically show that children of ethnic minorities have higher HbA 1c levels [13][14][15][16]. However, it remains unclear whether this poorer metabolic control is independent of SES, and many of the studies examined selected cohorts that may not be representative of the general population [2,[17][18][19].…”

Transition From Pediatric to Adult Care for Youth Diagnosed With Type 1 Diabetes in Adolescence

“…Previous research has suggested that African American and Hispanic youth are at risk for poor glycemic control while in pediatric care, although some studies have found that socioeconomic variables account for this effect. 7,17,18 Young adults from minority racial/ethnic backgrounds are considered at increased risk of poor transition outcomes. 19 Given our findings, this warrants further evaluation in future studies.…”