Racial Disparity in A1C Independent of Mean Blood Glucose in Children With Type 1 Diabetes

Kamps, Jodi L.; Hempe, James M.; Chalew, Stuart A.

doi:10.2337/dc09-1440

Cited by 86 publications

(72 citation statements)

References 14 publications

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“…We noted higher A1C levels in the vitamin D deficient (<37.5 nmol/L) group but this difference was not significant when controlling for ethnicity, suggesting that vitamin D may not exert a significant independent role in metabolic control. Nonetheless the results draw attention to discrepancies in A1C between ethnic groups, a finding previously described (43). Moreover, our study showed an increased risk of vitamin D deficiency in our type 1 diabetes cohort with increasing BMI.…”

Section: Discussionsupporting

confidence: 76%

Type 1 Diabetes as a Risk Factor for Impaired Vitamin D Status in a Multi-Ethnic Cohort of Canadian Adolescents

Yeshayahu

Sochett

Deda

et al. 2012

Canadian Journal of Diabetes

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Section: Discussionsupporting

confidence: 76%

Type 1 Diabetes as a Risk Factor for Impaired Vitamin D Status in a Multi-Ethnic Cohort of Canadian Adolescents

Yeshayahu

Sochett

Deda

et al. 2012

Canadian Journal of Diabetes

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“…Individuals with HbA1c values persistently lower or higher than expected relatively to their blood glucose levels have been identified in several studies where blood glucose was estimated based on fasting plasma glucose [22], self- [18,19,31,32], continuous glucose monitoring data [20,33], and classified as high or low glycators. HGI is a measure of the disagreement between the observed value of HbA1c and the one predicted on the basis of blood glucose levels and it is thought to be an indicator of the degree of hemoglobin glycation.…”

Section: Discussionmentioning

confidence: 99%

Association between hemoglobin glycation index and hepatic steatosis in non-diabetic individuals

Fiorentino

Marini

Succurro

et al. 2017

Diabetes Research and Clinical Practice

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Hemoglobin glycation indexHepatic steatosis Non-enzymatic protein glycation A B S T R A C TAims: Hemoglobin glycation index (HGI), which is the difference between the observed value of HbA1 and the predicted HbA1c based on plasma glucose levels, represents a measure of the degree of non-enzymatic glycation of hemoglobin and it has been found to be positively associated with diabetic complications. Herein we investigated whether HGI is associated with hepatic steatosis and related biomarkers in subjects without diabetes.Methods: 1120 White individuals without diabetes were stratified in quartiles according to HGI levels. Hepatic steatosis was diagnosed by ultrasonography.Results: As compared with subjects in the lowest quartile of HGI those in the intermediate and high HGI groups displayed an unfavorable cardio-metabolic risk profile having significantly higher values of body mass index (BMI), waist circumference, % fat mass, total cholesterol, triglycerides, inflammatory markers such as high sensitivity C reactive protein, erythrocytes sedimentation rate, complement C3, platelets and white blood cell count, hepatic insulin resistance assessed by the liver IR index and lower concentrations of highdensity lipoprotein. HGI was positively associated with the biomarker of liver damage alanine aminotransferase, and fatty liver index, an indicator of hepatic steatosis. In a logistic regression analysis adjusted for age, gender and BMI individuals in the highest quartile of HGI exhibited a 1.6-fold increased odd of having hepatic steatosis (95% CI: 1.03-2.41; p = 0.03) as compared with subjects in the lowest quartile of HGI.Conclusions: Higher levels of HGI may identify subjects without diabetes at increased risk of having hepatic steatosis.

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“…Furthermore, HbA1c levels were higher in black children from the uppermost SES strata than among the white children in the lowest of our SES echelons. [20][21][22] An analysis of available blood glucose data obtained from meter downloads, however, suggests that the racial disparity in HbA1c was accompanied by a similar disparity in mean blood glucose levels. Language barriers have been suggested to contribute to treatment problems, especially in exclusively Spanish-speaking, lowincome Hispanic families.…”

Section: Figurementioning

confidence: 99%

Racial-Ethnic Disparities in Management and Outcomes Among Children With Type 1 Diabetes

et al. 2015

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BACKGROUND AND OBJECTIVES: Previous research has documented racial/ethnic disparities in diabetes treatments and outcomes. It remains controversial whether these disparities result from differences in socioeconomic status (SES) or other factors. We examined racial/ethnic disparities in therapeutic modalities and diabetes outcomes among the large number of pediatric participants in the T1D Exchange Clinic Registry. METHODS: The cohort included 10 704 participants aged <18 years with type 1 diabetes for ≥1 year (48% female; mean age: 11.9 ± 3.6 years; diabetes duration: 5.2 ± 3.5 years). Diabetes management and clinical outcomes were compared among 8841 non-Hispanic white (white) (83%), 697 non-Hispanic black (black) (7%), and 1166 Hispanic (11%) participants. The population included 214 high-income black and Hispanic families. RESULTS: Insulin pump use was higher in white participants than in black or Hispanic participants (61% vs 26% and 39%, respectively) after adjusting for gender, age, diabetes duration, and SES (P < .001). Mean hemoglobin A1c was higher (adjusted P < .001) in black participants than in white or Hispanic participants (9.6%, 8.4%, and 8.7%). More black participants experienced diabetic ketoacidosis and severe hypoglycemic events in the previous year than white or Hispanic participants (both, P < .001). There were no significant differences in hemoglobin A1c, diabetic ketoacidosis, or severe hypoglycemia between white and Hispanic participants after adjustment for SES. CONCLUSIONS: Even after SES adjustment, marked disparities in insulin treatment method and treatment outcomes existed between black versus Hispanic and white children within this large pediatric cohort. Barriers to insulin pump use and optimal glycemic control beyond SES should be explored in all ethnic groups.

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Racial Disparity in A1C Independent of Mean Blood Glucose in Children With Type 1 Diabetes

Cited by 86 publications

References 14 publications

Type 1 Diabetes as a Risk Factor for Impaired Vitamin D Status in a Multi-Ethnic Cohort of Canadian Adolescents

Type 1 Diabetes as a Risk Factor for Impaired Vitamin D Status in a Multi-Ethnic Cohort of Canadian Adolescents

Association between hemoglobin glycation index and hepatic steatosis in non-diabetic individuals

Racial-Ethnic Disparities in Management and Outcomes Among Children With Type 1 Diabetes

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