title: The effect of insulin intensification in children and young persons with Type 1 diabetes differs in relation to ethnic group; a prospective observational study.
abstract: OBJECTIVE
  We prospectively evaluated the effect of insulin intensification on glycaemic control and lipid levels in children and young persons with Type 1 diabetes in relation to ethnicity.
  
  
  METHODS
  In the first 2 years of a 3-year observation period, as part of routine clinical care, 231 children and young persons (40% white, 28% South Asian, 32% black) from a single clinic were offered intensive insulin therapy. After 2 years, 222 were on intensive therapy and their data were compared between ethnic groups at the end of year 3.
  
  
  RESULTS
  We observed ethnic differences in HbA(1c) levels during the study [study beginning and end: white children and young persons 77 and 70 mmol/mol (9.2 and 8.6%) vs. South Asian 72 and 68 mmol/mol (8.7 and 8.4%) vs. black 83 and 79 mmol/mol (9.7 and 9.4%), P-value for ANCOVA = 0.007]. By study end, South Asians had the lowest HDL cholesterol (2.0 vs. 1.4 vs. 1.6 mmol/l, P-value = 0.03) and highest triglyceride levels (0.9 vs. 1.8 vs. 1.0 mmol/l, P-value = 0.001). In linear mixed modelling, after adjustment for socio-economic deprivation and other covariates: (1) black ethnicity was associated with poorer glycaemic control (P < 0.001) and (2) South Asian ethnicity was associated with higher triglyceride levels (P < 0.001), independent of HbA(1c).
  
  
  CONCLUSIONS
  The effect of insulin intensification on glycaemic control and lipid profile in children and young persons with Type 1 diabetes differs in relation to ethnic group.
authors.affiliation: Department of Paediatric Endocrinology and Diabetes, Royal London Hospital, London, UK.
authors.forename: R P
authors.initials: RP
authors.lastname: Dias
authors.forename: F
authors.initials: F
authors.lastname: Brown
authors.forename: C
authors.initials: C
authors.lastname: Wyatt
authors.forename: S
authors.initials: S
authors.lastname: Cheema
authors.forename: J
authors.initials: J
authors.lastname: Allgrove
authors.forename: R
authors.initials: R
authors.lastname: Amin
mesh_terms: D000293:Adolescent; D000704:Analysis of Variance; D001211:Asia, Western / Q000208:ethnology; D044383:Black People / Q000208:ethnology; D001786:Blood Glucose / Q000378:metabolism; D002648:Child; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000188:drug therapy* / Q000208:ethnology; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D054624:Health Status Disparities; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage*; D007267:Injections; D007332:Insulin Infusion Systems; D061385:Insulins / Q000008:administration & dosage*; D050356:Lipid Metabolism / Q000187:drug effects; D008131:London / Q000453:epidemiology; D008297:Male; D011446:Prospective Studies
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; D061385:Insulins