Self-reported social class, self-management behaviors, and the effect of diabetes mellitus in urban, minority young people and their families.
OBJECTIVE
To document social factors, diabetes mellitus (DM) self-management, and the effect of the disease among children with DM residing in Chicago, Ill.


METHODS
Patients were ascertained for a population-based study of childhood-onset DM (ages, 0-17 years). Families and patients (N = 288) were interviewed about health services use, sociodemographics, self-management behaviors, and other characteristics, a mean of 6.1 years after diagnosis. Univariate and multivariate analyses were conducted.


RESULTS
Most patients were non-Hispanic black (68.4%) or Hispanic (28.5%). Overall, 59.8% of the respondents received Medicaid or had no health insurance at the time of disease onset, including 61.7% of non-Hispanic black patients and 59.2% of Hispanic patients. Of the entire group, 61.5% reported that having DM had affected their family life in some way, with 14.9% reporting difficulty in obtaining child care and 18.4% reporting an effect on the parent and/or guardian's job. Having DM negatively affected the personal lives of 33.7% of the young people, with 13.9% having been excluded from sports activities, and 16.8% having had difficulty obtaining insurance. Among the 64 patients who were aged 20 years or older when interviewed, 21.0% had been denied employment because of their DM. The level of blood glucose was measured less than once daily by 8.8% of the respondents, while 12.4% had never been given a dilated ophthalmologic examination or had not been examined within the past year. Fully 30.6% of those aged 20 years or older smoked cigarettes. There were few ethnic differences in these characteristics.


CONCLUSIONS
We conclude that DM has had a significant effect in this group of primarily African American and Hispanic young people who have a chronic illness.
Lipton
Rebecca
R
Department of Pediatrics, University of Chicago Pritzker School of Medicine, Chicago, IL 60637, USA. lipton@uchicago.edu
Drum
Melinda
M
Burnet
Deborah
D
Mencarini
Maureen
M
Cooper
Andrew
A
Rich
Barry
B
D000293:Adolescent; D001741:Black or African American / Q000706:statistics & numerical data*; D016009:Chi-Square Distribution; D002641:Chicago / Q000453:epidemiology; D002648:Child; D003922:Diabetes Mellitus, Type 1 / Q000453:epidemiology* / Q000628:therapy; D005260:Female; D006630:Hispanic or Latino / Q000706:statistics & numerical data*; D006801:Humans; D016015:Logistic Models; D008297:Male; D012648:Self Care; D012923:Social Class; D014505:Urban Population