Jacobsen Joanna J, Black Mary Helen, Li Bonnie H, Reynolds Kristi, Lawrence Jean M
Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena CA, USA.
Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena CA, USA.
J Diabetes Complications. 2014 May-Jun;28(3):279-85. doi: 10.1016/j.jdiacomp.2014.01.010. Epub 2014 Jan 23.
To assess associations between race/ethnicity, glycated hemoglobin (HbA1c), and glycemic control among youth with type 1 (T1D) or type 2 diabetes (T2D).
The study sample was youth<20years old from the SEARCH California Center diagnosed from 2002 to 2009 who remained insured for at least one year. HbA1c at one year was from clinical data; HbA1c at diagnosis was from clinical data (81%) or imputed (19%). Multivariable logistic and linear regression models were used to examine associations between race/ethnicity and poor glycemic control (≥9.5%), HbA1c at one-year, and change in HbA1c.
The study included 1162 Hispanic (52.3%), non-Hispanic White (NHW, 28.4%), African American (15.1%) and Asian/Pacific Islander (4.1%) youth. Among T1D youth (n=789), Hispanics were 1.60 times as likely (95% CI 1.01-2.53) to have poor control at one year compared to NHWs, after adjustments. Among T2D youth (n=373), only African American youth were significantly more likely (OR=4.85; 95% CI 1.49-15.77) to have poor control at one year, after adjustments. HbA1c at one year and change in HbA1c did not differ by race/ethnicity.
Poor glycemic control was evident one year after diagnosis in some minority youth with T1D or T2D in an integrated managed health care setting.
评估1型糖尿病(T1D)或2型糖尿病(T2D)青少年的种族/族裔、糖化血红蛋白(HbA1c)与血糖控制之间的关联。
研究样本为2002年至2009年在加利福尼亚州SEARCH中心诊断出的20岁以下青少年,他们至少有一年的保险。一年时的HbA1c来自临床数据;诊断时的HbA1c来自临床数据(81%)或估算值(19%)。使用多变量逻辑回归和线性回归模型来检验种族/族裔与血糖控制不佳(≥9.5%)、一年时的HbA1c以及HbA1c变化之间的关联。
该研究纳入了1162名西班牙裔(52.3%)、非西班牙裔白人(NHW,28.4%)、非裔美国人(15.1%)和亚裔/太平洋岛民(4.1%)青少年。在T1D青少年(n = 789)中,调整后,西班牙裔青少年在一年时血糖控制不佳的可能性是NHW青少年的1.60倍(95% CI 1.01 - 2.53)。在T2D青少年(n = 373)中,调整后,只有非裔美国青少年在一年时血糖控制不佳的可能性显著更高(OR = 4.85;95% CI 1.49 - 15.77)。一年时的HbA1c和HbA1c变化在不同种族/族裔之间没有差异。
在综合管理的医疗保健环境中,一些患有T1D或T2D的少数族裔青少年在诊断后一年血糖控制不佳的情况很明显。