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Hemoglobin A1c,frequency of glucose testing and social disadvantage: Metrics of racial health disparity in youth with type 1 diabetes
Authors:Stuart Chalew  Ricardo Gomez  Alfonso Vargas  Jodi Kamps  Brittney Jurgen  Richard Scribner  James Hempe
Affiliation: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;2. 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;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
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?p?p?p?p?p?p?

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.
Keywords:IDM  insulin delivery method  BGS/d  home blood glucose tests performed per day  SMBG  self-monitored blood glucose  MEA  maternal educational attainment  CDI  concentrated disadvantage index  DSC  Depression Scale for Children  T1D  type 1 diabetes  MBG  mean blood glucose  HbA1c  hemoglobin A1c  Frequency of glucose testing  HbA1c  Children  Type 1 diabetes  Racial disparity  Home glucose monitoring
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