Disparity in glycemic control and adherence between African-American and Caucasian youths with diabetes. Family and community contexts.
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?


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.
Auslander
W F
WF
George Warren Brown School of Social Work, Washington University, St. Louis, MO 63130, USA.
Thompson
S
S
Dreitzer
D
D
White
N H
NH
Santiago
J V
JV
D000293:Adolescent; D000328:Adult; D001741:Black or African American / Q000523:psychology; D044383:Black People; D001786:Blood Glucose / Q000378:metabolism*; D017028:Caregivers; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D003710:Demography; D003922:Diabetes Mellitus, Type 1 / Q000097:blood* / Q000523:psychology*; D004493:Education; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008923:Missouri; D010349:Patient Compliance; D012044:Regression Analysis; D012737:Sex Factors; D012959:Socioeconomic Factors; D013315:Stress, Psychological; D011795:Surveys and Questionnaires; D044465:White People / Q000523:psychology
D001786:Blood Glucose