Racial Disparity in A1C Independent of Mean Blood Glucose in Children With Type 1 Diabetes

  1. Stuart A. Chalew, MD2,3,4
  1. 1Department of Psychology, Children's Hospital, New Orleans, Louisiana;
  2. 2Department of Pediatrics, Louisiana State University Health Sciences Center, New Orleans, Louisiana;
  3. 3Children's Hospital Research Institute for Children, New Orleans, Louisiana;
  4. 4Department of Endocrinology, Children's Hospital, New Orleans, Louisiana.
  1. Corresponding author: Jodi L. Kamps, jkamps{at}


OBJECTIVE Mean blood glucose (MBG) and MBG-independent factors both influence A1C levels. Race was related to A1C independent of MBG in adults. The goal of this study was to determine if racial disparity exists in A1C independent of MBG in children with diabetes.

RESEARCH DESIGN AND METHODS Participants included 276 children with type 1 diabetes. A1C and MBG were obtained from multiple clinic visits, and a hemoglobin glycation index (HGI) (an assessment of A1C levels independent of MBG) was calculated. A1C and HGI were analyzed controlling for age, diabetes duration, and MBG.

RESULTS African Americans had statistically significantly higher A1C (9.1 ± 0.1) and HGI (0.64 ± 0.11) than Caucasians (A1C 8.3 ± 0.1, HGI −0.15 ± 0.07) independent of covariates.

CONCLUSIONS Because of racial disparity in A1C, which is independent of MBG, we recommend that A1C and MBG be used together to make therapeutic decisions for children with diabetes.


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    • Received August 3, 2009.
    • Accepted February 8, 2010.

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  1. Diabetes Care vol. 33 no. 5 1025-1027
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