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Social determinants of health on glycemic control in pediatric type 1 diabetes

Caroline S Zuijdwijk1, Meaghan Cuerden, Farid H Mahmud

  • 1Division of Endocrinology, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada. czuijdwijk@cheo.on.ca

The Journal of Pediatrics
|January 31, 2013
PubMed

Insights

Social and material deprivation are linked to poorer glycemic control in children with type 1 diabetes (T1D). Insulin pump use may mitigate these effects, improving blood sugar management in this vulnerable population.

Area of Science:

  • Pediatric Endocrinology
  • Public Health
  • Health Disparities

Background:

  • Social determinants of health (SDH) significantly impact chronic disease management.
  • Understanding SDH is crucial for addressing health inequities in pediatric type 1 diabetes (T1D).

Purpose of the Study:

  • To investigate the association between SDH and glycemic control (A1C) in a large pediatric T1D cohort.
  • To explore potential moderating effects of insulin pump therapy on this relationship.

Main Methods:

  • Utilized Deprivation Indices (DI) based on postal codes to assess socioeconomic status, family structure, and ethnicity.
  • Linked DI quintiles to mean A1C levels in 854 pediatric T1D patients.
  • Performed regression analysis controlling for age, sex, and insulin pump use.

Main Results:

  • Higher A1C levels were observed in patients from more deprived socioeconomic backgrounds (Material DI, Social DI).
  • Ethnic concentration also showed a weaker association with higher A1C.
  • These SDH-related associations with A1C were not significant in patients using insulin pump therapy.

Conclusions:

  • Material and social deprivation are significant factors associated with suboptimal glycemic control in pediatric T1D.
  • Insulin pump therapy may play a moderating role, potentially improving glycemic outcomes despite socioeconomic challenges.
Abstract

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