Disparity in glycemic control and adherence between African-American and Caucasian youths with diabetes: family and community contexts

• Published in: Diabetes care Vol. 20; no. 10; pp. 1569 - 1575
• Main Authors: Auslander, W.F. (Washington University, St. Louis, MO.), Thompson, S, Dreitzer, D, White, N.H, Santiago, J.V
• Format: Journal Article
• Language: English
• Published: Alexandria, VA American Diabetes Association 01.10.1997
• Subjects: Adolescent; Adult; African Americans - psychology; African Continental Ancestry Group; Biological and medical sciences; BLACKS; Blood Glucose - metabolism; BLOOD SUGAR; BLOOD SUGAR CONTROL; Caregivers; Child; Child, Preschool; Cross-Sectional Studies; Demography; DIABETES; Diabetes Mellitus, Type 1 - blood; Diabetes Mellitus, Type 1 - psychology; Diabetes. Impaired glucose tolerance; Education; Endocrine pancreas. Apud cells (diseases); Endocrinopathies; ETHNIC GROUPS; ETHNICITY; European Continental Ancestry Group - psychology; FAMILIES; FAMILY ENVIRONMENT; Female; Humans; Male; Management. Various non-drug treatments. Langerhans islet grafts; Medical sciences; Middle Aged; Missouri; Patient Compliance; Regression Analysis; Sex Factors; SOCIAL STRUCTURE; Socioeconomic Factors; SOCIOECONOMIC STATUS; Stress, Psychological; Surveys and Questionnaires; YOUTH; Missouri; Endocrinopathy; Human; Social status; Demography; Surveillance; Diabetes mellitus; Distribution; Race; Negroid; Caucasoid; Comparative study; Glycemia
• ISSN: 0149-5992; 1935-5548
• DOI: 10.2337/diacare.20.10.1569

Disparity in glycemic control and adherence between African-American and Caucasian youths with diabetes. Family and community contexts. W F Auslander , S Thompson , D Dreitzer , N H White and J V Santiago George Warren Brown School of Social Work, Washington University, St. Louis, MO 63130, USA. Abstract OBJECTIVE: To describe sociodemographic, family, and community factors that contribute to the glycemic control of African-American and Caucasian youths with diabetes, we investigated two questions: 1) Is there a disparity in glycemic control between African-American and Caucasian youths with diabetes, and if so, what sociodemographic, family, and community factors explain the disparity? and 2) Is there a difference in the adherence to treatment between African-American and Caucasian youths with diabetes, and if so, what sociodemographic, family, and community factors explain the difference? RESEARCH DESIGN AND METHODS: This cross-sectional study included 146 youths with diabetes (95 Caucasians and 51 African-Americans) and their mothers. The youths were invited to participate if they had been diagnosed with diabetes at least 1 year before the study, did not have another chronic illness, and were < 18 years of age. RESULTS: The findings indicate that African-American youths with diabetes are in significantly poorer metabolic control than their Caucasian counterparts (1.5% difference in HbA1c levels). Single-parent household status and lower levels of adherence partially account for the poorer glycemic control. Examination of the adherence subscales indicates that African-Americans report significantly lower adherence to diet and glucose testing than Caucasian youths. CONCLUSIONS: This study suggests that African-American youths with diabetes may be at greater risk for poor glycemic control due to the higher prevalence of single parenting and lower levels of adherence found in this population.