Department of Pediatrics, Baylor College of Medicine.
Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine.
J Pediatr Psychol. 2017 Oct 1;42(9):933-940. doi: 10.1093/jpepsy/jsx092.
This study examines whether race/ethnicity moderates relationships of (a) diabetes stress and general life stressors with (b) diabetes outcomes of glycemic control and diabetic ketoacidosis (DKA) among emerging adults (aged 18-25 years) with type 1 diabetes (T1D).
Using a T1D Exchange Registry sample of non-Hispanic White, African American, and Hispanic emerging adults (N = 3,440), multiple group analyses were used to determine whether race/ethnicity moderates the relationships between stress and diabetes outcomes.
The relationships between the two stress types and glycemic control did not differ between African American and non-Hispanic Whites. However, as compared with non-Hispanic Whites, the association between higher diabetes-specific stress and poorer glycemic control was significantly stronger for Hispanics, and Hispanics had poorer glycemic control when they experienced a relatively fewer number of general life stressors than non-Hispanic Whites. The relationships between the type of stress (diabetes-specific and general stress) and DKA did not differ across racial/ethnic groups.
Future research should evaluate possible mechanisms that contribute to the different relationships of stress with glycemic control among Hispanics compared with non-Hispanic Whites.
本研究旨在探讨种族/民族是否调节（a）糖尿病应激和一般生活应激源与（b）18-25 岁 1 型糖尿病（T1D）成年患者血糖控制和糖尿病酮症酸中毒（DKA）的糖尿病结局之间的关系。
利用 T1D 交换注册研究中非西班牙裔白人、非裔美国人和西班牙裔新兴成年人（N=3440）的样本，采用多组分析来确定种族/民族是否调节了应激与糖尿病结局之间的关系。
两种应激类型与血糖控制之间的关系在非西班牙裔白人和非裔美国人之间没有差异。然而，与非西班牙裔白人相比，西班牙裔人糖尿病特异性应激与血糖控制较差之间的关联更强，而且当他们经历的一般生活应激源相对较少时，西班牙裔人的血糖控制较差。应激类型（糖尿病特异性和一般应激）与 DKA 之间的关系在不同种族/民族群体中没有差异。
未来的研究应该评估可能导致西班牙裔人与非西班牙裔白人之间应激与血糖控制关系不同的机制。
