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Ethnicity and social deprivation independently influence metabolic control in children with type 1 diabetes

P J Carter1, W S Cutfield, P L Hofman

  • 1Paediatric Diabetes Service, Greenlane Clinical Centre, Starship Children's Health, Auckland, New Zealand.

Diabetologia
|August 6, 2008
PubMed

Insights

Ethnicity and socioeconomic status (SES) significantly impact metabolic control in children with type 1 diabetes. Maori and Pacific children face higher risks of hypoglycemia and complications, regardless of SES.

Area of Science:

  • Pediatrics
  • Endocrinology
  • Public Health

Background:

  • Type 1 diabetes management in children requires ongoing monitoring.
  • Metabolic control, indicated by HbA1c levels, is crucial for preventing long-term complications.
  • Socioeconomic status (SES) and ethnicity may influence health outcomes in pediatric populations.

Purpose of the Study:

  • To assess the impact of ethnicity and SES on metabolic control in children with type 1 diabetes.
  • To determine if SES mediates the relationship between ethnicity and HbA1c levels.
  • To identify factors associated with poorer metabolic control in pediatric type 1 diabetes.

Main Methods:

  • Retrospective review of 555 pediatric patients (<16 years) with type 1 diabetes from 1995-2005 in Auckland, New Zealand.
  • Prospective collection of diabetes care variables and HbA1c values during clinic visits.
  • Multiple linear regression analysis to identify independent predictors of HbA1c levels.

Main Results:

  • Mean HbA1c was 8.3 +/- 1.3%.
  • Maori and Pacific children exhibited poorer metabolic control (HbA1c 9.1-9.3%) and higher hypoglycemia rates compared to European children (HbA1c 8.1%).
  • Ethnicity and SES were independently associated with HbA1c; longer diabetes duration, higher insulin dose, lower BMI z-score, and less frequent glucose monitoring also correlated with higher HbA1c.

Conclusions:

  • Both ethnicity and SES independently affect metabolic control in children with type 1 diabetes.
  • Maori and Pacific youth with type 1 diabetes have an elevated risk of hypoglycemia and long-term complications, irrespective of their SES.
  • These findings highlight the need for culturally sensitive and socioeconomically informed diabetes care strategies for diverse pediatric populations.
Abstract

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