Racial Disparity in Hemoglobin A1c Independent of Mean Blood Glucose in Children with Type 1 Diabetes

  1. Stuart A. Chalew, M.D.2,3,4
  1. 1 Children's Hospital, Department of Psychology
  2. 2 Louisiana State University Health Sciences Center, Department of Pediatrics
  3. 3 Children's Hospital Research Institute for Children
  4. 4 Children's Hospital, Department of Endocrinology


Objective: Mean blood glucose (MBG) and MBG-independent factors both influence HbA1c levels. Race was related to HbA1c independent of MBG in adults. The goal of this study was to determine if racial disparity exists in HbA1c independent of MBG in children with diabetes.

Research Design and Methods: Participants included 276 children with type 1 diabetes. HbA1c and MBG were obtained from multiple clinic visits and a hemoglobin glycation index (HGI, an assessment of HbA1c levels independent of MBG) was calculated. HbA1c and HGI were analyzed controlling for age, diabetes duration, and MBG.

Results: African Americans had statistically significantly higher HbA1c (9.1±0.1) and HGI (0.64±0.11) compared to Caucasians (HbA1c = 8.3±0.1, HGI = −0.15±0.07) independent of covariates.

Conclusions: Due to racial disparity in HbA1c which is independent of MBG, we recommend that HbA1c and MBG be used together to make therapeutic decisions for children with diabetes.


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

This Article

  1. Diabetes Care
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