Ethnicity and social deprivation independently influence metabolic control in children with type 1 diabetes.
OBJECTIVE
This study was performed to evaluate the influence of ethnicity and socioeconomic status (SES) on metabolic control in a population-based cohort of children with type 1 diabetes mellitus, and to evaluate whether any relationship between ethnicity and HbA(1c) is mediated by SES.


METHODS
We performed a retrospective review of all patients under age 16 years with type 1 diabetes (n = 555) from 1995 to 2005 in the greater Auckland region, New Zealand. Diabetes care variables and HbA(1c) values were collected prospectively, during clinic visits.


RESULTS
The mean population HbA(1c) was 8.3 +/- 1.3%. Maori and Pacific patients had poorer metabolic control than their European counterparts (9.1% and 9.3% vs 8.1%, p < 0.001) and higher rates of moderate to severe hypoglycaemia (31.1 and 24.8 vs 14.9 events/100 patient-years, p = 0.03). In multiple linear regression analysis, both ethnicity and SES were independently associated with HbA(1c) (p < 0.001). Other factors associated with higher HbA(1c) level were longer duration of diabetes, higher insulin dose, lower BMI z score and less frequent blood glucose monitoring (p < 0.001).


CONCLUSIONS
Both ethnicity and SES independently influenced metabolic control in a large, unselected population of children with type 1 diabetes. Irrespective of SES, Maori and Pacific youth with type 1 diabetes were at greater risk of both moderate to severe hypoglycaemia and long-term complications associated with poor metabolic control.
Carter
P J
PJ
Paediatric Diabetes Service, Greenlane Clinical Centre, Starship Children's Health, Auckland, New Zealand.
Cutfield
W S
WS
Hofman
P L
PL
Gunn
A J
AJ
Wilson
D A
DA
Reed
P W
PW
Jefferies
C
C
D000293:Adolescent; D000704:Analysis of Variance; D044466:Asian People / Q000208:ethnology; D002648:Child; D002675:Child, Preschool; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000208:ethnology* / Q000378:metabolism*; D005060:Europe / Q000208:ethnology; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D007223:Infant; D008297:Male; D009520:New Zealand / Q000453:epidemiology; D012923:Social Class
D006442:Glycated Hemoglobin