Racial Disparities on Glycemic Control and Lipid Profiles in Children with Type 1 Diabetes

Abstract

Objective: We assessed the racial (Black-White) differences in glycemic control, prevalence of abnormal lipid profi les and factors infl uencing temporal trends in children with type 1 diabetes (T1DM).Methods: This retrospective study was done in children with T1DM. The outcome measure was based on glycemic control and all lipid determinations which were stratifi ed according to the published guidelines. Results:The study included 181 children; 76.2% Whites and 23.8% Blacks. The mean glycated hemoglobin (A1C) was higher in Blacks than in Whites (p Ͻ 0.0001). Blacks had elevated total cholesterol (TC) (p = 0.0013), lower TC/HDL ratio (p Ͻ 0.0001) and higher concentration of HDL (Ͻ0.0001) when compared to Whites. The longitudinal analyses over a 5 year period showed changes in A1C signifi cantly associated with changes in the lipid profi les. The lipid profi les in Blacks were more altered by the trend in A1C with changes in the TC (p = 0.0079), non-HDL (p Ͻ 0.0001) and HDL (p Ͻ 0.0001).Conclusions: Black children with T1DM have poorer glycemic control. However they retained excellent levels of HDL when compared to Whites.

Demographic and personal factors associated with metabolic control and self‐care in youth with type 1 diabetes: a systematic review

“…The variables of race and ethnicity are often confounded by ethnic minority status, socioeconomic deprivation, and language and cultural impediments to accessing health care resources. Belonging to an ethnic minority or immigrant population is a strong predictor of both suboptimal glycaemic control and low self‐management; this link has been replicated across the US, Europe and Australasia . The disparity between African‐American and Caucasian youths with diabetes has been well‐described, with a difference of 1.5–1.9% in HbA 1c attributed to a higher prevalence of single parenting, higher proportion of people from lower SES, and lower levels of self‐care .…”