Department of Pediatrics, Baylor College of Medicine, Texas Children's Hospital, Houston, Texas, USA.
School of Social Work, Western Michigan University, Kalamazoo, Michigan, USA.
Pediatr Diabetes. 2020 Sep;21(6):979-986. doi: 10.1111/pedi.13061. Epub 2020 Jun 23.
Emerging adulthood is a vulnerable period for poor blood glucose control and self-management behaviors (SMBs) among individuals with type 1 diabetes. Racial/ethnic minority young adults have poorer glycemic outcomes than non-Hispanic whites; however, little is known about possible racial/ethnic differences in frequency of SMBs among emerging adults (EAs).
To examine racial/ethnic differences in SMBs and to determine associations between SMBs and blood glucose control.
A sample of EAs (ages 18-25 years; N = 3456) from the type 1 diabetes exchange registry was used to conduct multivariate analyses to examine (a) racial/ethnic differences in SMBs and (b) associations between SMBs and blood glucose control for each racial/ethnic group.
Compared to non-Hispanic whites, African Americans and Hispanics less frequently took an insulin bolus for snacks, less frequently checked blood glucose with a meter, and were more likely to not use insulin to carbohydrate ratios. African Americans also less frequently checked blood glucose prior to mealtime boluses and more frequently missed insulin doses. SMBs that were associated with blood glucose control across groups were frequency of checking blood glucose at mealtime, missing an insulin dose, and checking blood glucose with a meter.
Promoting two SMBs: checking blood glucose and taking insulin doses as needed among African American EAs may be important to address racial disparities in glycemic outcomes. Future research should evaluate possible social and contextual mechanisms contributing to low engagement in these behaviors among African Americans to inform strategies to address racial differences in glycemic outcomes.
在 1 型糖尿病患者中，成年初显期是血糖控制和自我管理行为（SMB）较差的脆弱时期。与非西班牙裔白人相比，少数族裔年轻成年人的血糖控制结果更差；然而，对于成年初显期（EA）人群中 SMB 的频率是否存在种族/民族差异，知之甚少。
检查 SMB 中的种族/民族差异，并确定 SMB 与血糖控制之间的关联。
使用 1 型糖尿病交换注册处的 EA 样本（年龄 18-25 岁；N=3456）进行多变量分析，以检查 SMB 中的种族/民族差异和 SMB 与每个种族/民族群体的血糖控制之间的关联。
与非西班牙裔白人相比，非裔美国人和西班牙裔人较少因零食而注射胰岛素，较少用血糖仪检查血糖，且更不可能使用胰岛素与碳水化合物的比例。非裔美国人也较少在餐前服用胰岛素前检查血糖，更频繁地错过胰岛素剂量。与血糖控制相关的 SMB 是在进餐时检查血糖、漏注胰岛素剂量和使用血糖仪检查血糖的频率。
在 EA 中，促进两种 SMB：检查血糖和根据需要服用胰岛素剂量，可能对解决血糖控制结果的种族差异很重要。未来的研究应该评估在非裔美国人中，这些行为参与度低的可能的社会和环境机制，为解决血糖控制结果的种族差异提供策略。
