Hemoglobin A1c, frequency of glucose testing and social disadvantage: Metrics of racial health disparity in youth with type 1 diabetes

The Relationships Among School Nurse to Student Ratios, Self-Efficacy, and Glycemic Control in Adolescents With Type 1 Diabetes

“…Recommendations for future research include utilizing a more heterogeneous sample, as recent literature has demonstrated disparities in access to care and treatment outcomes in diverse populations (Chalew et al, 2018; O’Connor, Carlin, Coker, Zierler, & Pihoker, 2019; Rose et al, 2018). Varied geographic locations and expanding the research question to include targeted school nursing interventions aimed at increasing self-efficacy for T1D management in the adolescent population are warranted.…”

Racial disparity in HbA1c persists when fructosamine is used as a surrogate for mean blood glucose in youth with type 1 diabetes

“…Thus, estimation of MBG from home meter data obtained over multiple days and weeks is labor intensive, costly, may be affected by equipment, patient technique and motivation, and sampling frequency . There may be variation in sampling frequency among patients of different race, income, and age . Use of a single day glucose profile sets or just a single fasting or single postprandial glucose sample also have limitations when trying to carefully define the relationship between MBG and HbA1c.…”

“…4 There may be variation in sampling frequency among patients of different race, income, and age. 24 Fructosamine refers to circulating plasma proteins, predominantly albumin, which have been non-enzymatically glycated in the circulation. Concurrent fructosamine levels are correlated with both MBG and HbA1c.…”

Inequities in Health Outcomes in Children and Adults With Type 1 Diabetes: Data From the T1D Exchange Quality Improvement Collaborative

“…Mean A1C levels were found to be higher in Hispanics and non-Hispanic Blacks with type 1 diabetes compared with non-Hispanic Whites in the largest U.S. study to date, which included ∼11,000 youths and young adults in the T1D Exchange clinic network and registry ( 4 ). Non-Hispanic Blacks and Hispanics have been reported to perform fewer blood glucose checks per day than Non-Hispanic Whites ( 5 , 6 ). One study evaluating A1C trajectories over time in ∼16,000 youths from Australia, Europe, and the United States found that minority groups were more likely to have increasing A1C levels over time compared with Non-Hispanic Whites, specifically in the T1D Exchange and Diabetes-Patienten-Verlaufsdokumentation registries ( 7 ).…”