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特色文章:比较早期青春期 1 型糖尿病的西班牙裔与白种非西班牙裔青少年的糖尿病管理轨迹。

Featured Article: Comparison of Diabetes Management Trajectories in Hispanic versus White Non-Hispanic Youth with Type 1 Diabetes across Early Adolescence.

机构信息

Department of Pediatrics, Kennedy Krieger Institute/Johns Hopkins School of Medicine, Baltimore, MD, USA.

Department of Clinical and School Psychology, Nova Southeastern University, Fort Lauderdale, FL, USA.

出版信息

J Pediatr Psychol. 2019 Jul 1;44(6):631-641. doi: 10.1093/jpepsy/jsz011.

Abstract

OBJECTIVE

Ethnic minority youth with type 1 diabetes (T1D) often have poorer glycemic control and lower rates of adherence compared to White Non-Hispanic (WNH) youth. Variables such as family conflict, autonomy support, and youth regimen responsibility have been shown to change over adolescence and impact diabetes management. However, these factors have been investigated in predominantly White samples. Few studies have examined potential differences in these variables and their trajectories for Hispanic youth over early adolescence.

METHODS

Youth with T1D (178 WNH and 33 Hispanic youth participants), as well as their maternal caregivers (174 WNH and 32 Hispanic maternal caregivers), completed measures of diabetes-specific autonomy support, diabetes-related family conflict, regimen responsibility, and blood glucose monitoring frequency at 4 timepoints over a 3-year period.

RESULTS

At baseline, Hispanic youth had significantly poorer glycemic control, more family conflict, and fewer blood glucose checks on average compared to WNH youth. Similar to WNH youth, Hispanic youth have increasing independence for regimen tasks and decreasing parent autonomy support during this developmental period. However, while Hispanic youth had worsening diabetes management during early adolescence (as did WNH youth), Hispanic parents reported a more gradual change in youth's diabetes management over early adolescence.

CONCLUSIONS

This study presents an important contribution to the existing literature on youth with T1D. Findings suggest potential strengths and targets for Hispanic youth navigating diabetes management during the adolescent period. It is important to continue to investigate the trajectories of ethnic minority youth with diabetes.

摘要

目的

与白人非西班牙裔(WNH)青年相比,少数民族青少年 1 型糖尿病(T1D)患者的血糖控制往往较差,且遵医率较低。家庭冲突、自主性支持以及青少年治疗方案责任等变量在青少年时期会发生变化,从而影响糖尿病管理。然而,这些因素已在主要为白人的样本中进行了研究。很少有研究调查过这些变量及其轨迹在西班牙裔青少年早期的潜在差异。

方法

178 名 WNH 青少年和 33 名西班牙裔青少年参与者及其母亲照顾者(174 名 WNH 和 32 名西班牙裔母亲照顾者)在 3 年内的 4 个时间点完成了糖尿病特定自主性支持、与糖尿病相关的家庭冲突、治疗方案责任以及血糖监测频率的测量。

结果

在基线时,与 WNH 青少年相比,西班牙裔青少年的血糖控制明显较差,家庭冲突更多,平均血糖监测次数更少。与 WNH 青少年相似,西班牙裔青少年在这一发育阶段逐渐独立承担治疗方案任务,而父母的自主性支持逐渐减少。然而,尽管西班牙裔青少年在青少年早期的糖尿病管理也在恶化(与 WNH 青少年一样),但西班牙裔父母报告说,青少年的糖尿病管理在青少年早期的变化更为渐进。

结论

本研究对 T1D 青少年的现有文献做出了重要贡献。研究结果表明,西班牙裔青少年在青少年时期管理糖尿病方面存在潜在的优势和目标。继续研究少数民族青少年糖尿病患者的轨迹非常重要。

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Type 1 diabetes in young adulthood.青年期1型糖尿病
Curr Diabetes Rev. 2015;11(4):239-50. doi: 10.2174/1573399811666150421114957.

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