Disparity in Glycemic Control and Adherence Between African-American and Caucasian Youths With Diabetes: Family and community contexts

Wendy F Auslander; Sanna Thompson; Daniele Dreitzer; Neil H White; Julio V Santiago

doi:10.2337/diacare.20.10.1569

Original Articles

Disparity in Glycemic Control and Adherence Between African-American and Caucasian Youths With Diabetes: Family and community contexts

Wendy F Auslander, PHD,
Sanna Thompson, MSW,
Daniele Dreitzer, MSW,
Neil H White, MD, CDE and
Julio V Santiago, MD†

George Warren Brown School of Social Work, Washington University School of Medicine St. Louis, Missouri
Washington University, Washington University School of Medicine, Department of Pediatrics St. Louis, Missouri

Address correspondence and reprint requests to Wendy E Auslander, PhD, George Warren Brown School of Social Work, Washington University, Campus Box 1196, St. Louis, MO 63130.

Diabetes Care 1997 Oct; 20(10): 1569-1575. https://doi.org/10.2337/diacare.20.10.1569

Abstract

OBJECTIVE To describe sociodemographic, family, and community factors that contribute to the glycemic control of African-American and Caucasian youths with diabetes, we investigated two questions: 1) Is there a disparity in glycemic control between African-American and Caucasian youths with diabetes, and if so, what sociodemographic, family, and community factors explain the disparity? and 2) Is there a difference in the adherence to treatment between African-American and Caucasian youths with diabetes, and if so, what sociodemographic, family, and community factors explain the difference?

RESEARCH DESIGN AND METHODS This cross-sectional study included 146 youths with diabetes (95 Caucasians and 51 African-Americans) and their mothers. The youths were invited to participate if they had been diagnosed with diabetes at least 1 year before the study, did not have another chronic illness, and were < 18 years of age.

RESULTS The findings indicate that African-American youths with diabetes are in significantly poorer metabolic control than their Caucasian counterparts (1.5% difference in HbA_1c levels). Single-parent household status and lower levels of adherence partially account for the poorer glycemic control. Examination of the adherence subscales indicates that African-Americans report significantly lower adherence to diet and glucose testing than Caucasian youths.

CONCLUSIONS This study suggests that African-American youths with diabetes may be at greater risk for poor glycemic control due to the higher prevalence of single parenting and lower levels of adherence found in this population.