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Migration Status in Relation to Clinical Characteristics and Barriers to Care Among Youth with Diabetes in the US |
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| Authors: | Lindsay M. Jaacks Reena Oza-Frank Ralph D’Agostino Jr. Lawrence M. Dolan Dana Dabelea Jean M. Lawrence Catherine Pihoker M. Rebecca O’Connor Barbara Linder Giuseppina Imperatore Michael Seid K. M. Venkat Narayan Elizabeth J. Mayer-Davis |
| Affiliation: | 1. Department of Nutrition, The University of North Carolina, 2211 McGavran-Greenberg Hall, 135 Dauer Drive, Campus Box 7461, Chapel Hill, NC, 27599, USA 2. Department of Pediatrics, Research Institute at Nationwide Children’s Hospital, The Ohio State University, Columbus, OH, USA 3. Department of Biostatistics, Wake Forest University School of Medicine, Winston-Salem, NC, USA 4. Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA 5. Department of Epidemiology, The University of Colorado, Denver, CO, USA 6. Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, CA, USA 7. Seattle Children’s Hospital, Seattle, WA, USA 8. National Institutes of Health, NIDDK, Bethesda, MD, USA 9. Center for Disease Control and Prevention, Atlanta, GA, USA 10. Hubert Department of Global Health, Emory University, Atlanta, GA, USA 11. Department of Medicine, The University of North Carolina, Chapel Hill, NC, USA |
| Abstract: | Migration status and the accompanying diversity in culture, foods and family norms, may be an important consideration for practitioners providing individualized care to treat and prevent complications among youth with diabetes. Approximately 20?% of youth in the US have ≥1 foreign-born parent. However, the proportion and characteristics of youth with diabetes and ≥1 foreign-born parent have yet to be described. Study participants (n?=?3,086) were from SEARCH for Diabetes in Youth, a prospective multi-center study in the US. Primary outcomes of interest included HbA1c, body mass index and barriers to care. Multivariable analyses were carried out using logistic regression and analysis of covariance. Approximately 17?% of participants with type 1 diabetes (T1D) and 22?% with type 2 diabetes (T2D) had ≥1 foreign-born parent. Youth with T1D and ≥1 foreign-born parent were less likely to have poor glycemic control [adjusted odds ratio (OR) (95?% confidence interval): 0.70 (0.53, 0.94)]. Among youth with T2D, those with ≥1 foreign-born parent had lower odds of obesity [adjusted OR (95?% CI): 0.35 (0.17, 0.70)]. This is the first study to estimate the proportion and characteristics of youth with diabetes exposed to migration in the US. Research into potential mechanisms underlying the observed protective effects is warranted. |
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