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Racial-ethnic disparities in management and outcomes among children with type 1 diabetes

Steven M Willi1, Kellee M Miller2, Linda A DiMeglio3

  • 1Children's Hospital of Philadelphia, Philadelphia, Pennsylvania;

Pediatrics
|February 18, 2015
PubMed

Insights

Racial disparities persist in pediatric type 1 diabetes care, with Black children experiencing worse outcomes and less insulin pump use than White or Hispanic children, even after accounting for socioeconomic status.

Area of Science:

  • Pediatric Endocrinology
  • Diabetes Research
  • Health Disparities

Background:

  • Previous research indicates racial/ethnic disparities in diabetes treatments and outcomes.
  • It remains debated whether these disparities stem from socioeconomic status (SES) or other factors.

Purpose of the Study:

  • To examine racial/ethnic disparities in therapeutic modalities and diabetes outcomes.
  • Focus on pediatric participants in the T1D Exchange Clinic Registry.

Main Methods:

  • Analyzed data from 10,704 pediatric participants (<18 years) with type 1 diabetes.
  • Compared diabetes management and outcomes among non-Hispanic white, non-Hispanic black, and Hispanic participants.
  • Adjusted for gender, age, diabetes duration, and socioeconomic status.

Main Results:

  • Insulin pump use was significantly lower in Black (26%) and Hispanic (39%) children compared to White children (61%), even after SES adjustment.
  • Black children had higher mean hemoglobin A1c (9.6%) and experienced more diabetic ketoacidosis and severe hypoglycemia than White (8.4%) or Hispanic (8.7%) children.
  • No significant differences in outcomes were found between White and Hispanic participants after SES adjustment.

Conclusions:

  • Significant disparities in insulin treatment and outcomes persist between Black children and White/Hispanic children, independent of SES.
  • Further research is needed to identify barriers to insulin pump use and optimal glycemic control beyond SES in all ethnic groups.
Abstract

Keywords:
diabetes managementethnicityglycemic controlracetype 1 diabetes

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