title: The effect of insurance status and parental education on glycemic control and cardiovascular disease risk profile in youth with Type 1 Diabetes.
abstract: BACKGROUND
  Adult studies have shown a correlation between low socioeconomic status and Type 1 Diabetes complications, but studies have not been done in children to examine the effect of socioeconomic status on risk for future complications. This study investigates the relationship between insurance status and parental education and both glycemic control and cardiovascular disease (CVD) risk factors in youth with type 1 diabetes.
  
  
  METHODS
  A cross-sectional study of 295 youth with established type 1 diabetes who underwent examination with fasting blood draw and reported insurance status and parental education.
  
  
  RESULTS
  Youth with type 1 diabetes and public insurance had higher hemoglobin A1c (HbA1c), body mass index, hs-CRP, and blood pressure (p < 0.05) than those with private insurance. Insulin regimen varied between insurance groups, and differences in HbA1c and CVD risk factors, except for diastolic blood pressure (DBP), were no longer evident after controlling for insulin regimen. Parental education was not associated with HbA1c or CVD risk factors.
  
  
  CONCLUSIONS
  Youth with type 1 diabetes and public insurance have worse glycemic control and elevated CVD risk factors compared to those with private insurance, but this was no longer seen when insulin regimen was controlled for. Further research is needed to look at differences between those with public insurance and private insurance that contribute to differences in type 1 diabetes outcomes, and to identify modifiable risk factors in pediatric patients in order to focus earlier interventions to decrease and prevent future diabetes complications.
authors: Department of Pediatrics, Children's Hospital Colorado, 13123 E. 16th Ave, Aurora, CO 80045, USA ; Barbara Davis Center for Childhood Diabetes, University of Colorado Denver, 1775 Aurora Ct, Aurora, CO 80045, USA.
authors: Shideh
authors: S
authors: Majidi
authors: Department of Pediatrics, Children's Hospital Colorado, 13123 E. 16th Ave, Aurora, CO 80045, USA ; Barbara Davis Center for Childhood Diabetes, University of Colorado Denver, 1775 Aurora Ct, Aurora, CO 80045, USA.
authors: R Paul
authors: RP
authors: Wadwa
authors: Barbara Davis Center for Childhood Diabetes, University of Colorado Denver, 1775 Aurora Ct, Aurora, CO 80045, USA.
authors: Franziska K
authors: FK
authors: Bishop
authors: Department of Pediatrics, Children's Hospital Colorado, 13123 E. 16th Ave, Aurora, CO 80045, USA ; Barbara Davis Center for Childhood Diabetes, University of Colorado Denver, 1775 Aurora Ct, Aurora, CO 80045, USA.
authors: Georgeanna J
authors: GJ
authors: Klingensmith
authors: Department of Pediatrics, Children's Hospital Colorado, 13123 E. 16th Ave, Aurora, CO 80045, USA ; Barbara Davis Center for Childhood Diabetes, University of Colorado Denver, 1775 Aurora Ct, Aurora, CO 80045, USA.
authors: Marian
authors: M
authors: Rewers
authors: Barbara Davis Center for Childhood Diabetes, University of Colorado Denver, 1775 Aurora Ct, Aurora, CO 80045, USA.
authors: Kim
authors: K
authors: McFann
authors: Department of Pediatrics, Children's Hospital Colorado, 13123 E. 16th Ave, Aurora, CO 80045, USA ; Barbara Davis Center for Childhood Diabetes, University of Colorado Denver, 1775 Aurora Ct, Aurora, CO 80045, USA.
authors: David M
authors: DM
authors: Maahs
keywords: Cardiovascular disease; Hemoglobin A1c; Parental education; Socioeconomic status; Type 1 diabetes