7-OR: Racial/Ethnic Differences in Barriers to Type 1 Diabetes (T1D) Self-Management between Non-Hispanic Black and Hispanic Young Adults (YA)

Diabetes ◽  
2021 ◽  
Vol 70 (Supplement 1) ◽  
pp. 7-OR
Author(s):  
MOLLY FINNAN ◽  
GLADYS CRESPO-RAMOS ◽  
SHIVANI AGARWAL
Keyword(s):  
Type 1 Diabetes ◽  
Young Adults ◽  
Ethnic Differences ◽  
Self Management ◽  
Racial Ethnic

scholarly journals Racial-Ethnic Inequity in Young Adults With Type 1 Diabetes

2020 ◽  
Vol 105 (8) ◽  
pp. e2960-e2969 ◽  
Author(s):  
Shivani Agarwal ◽  
Lauren G Kanapka ◽  
Jennifer K Raymond ◽  
Ashby Walker ◽  
Andrea Gerard-Gonzalez ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Young Adults ◽  
Technology Use ◽  
Self Management ◽  
Diabetes Distress ◽  
Diabetes Technology ◽  
Racial Ethnic ◽  
Hispanic White ◽  
Hba1c Levels

Abstract Context Minority young adults (YA) currently represent the largest growing population with type 1 diabetes (T1D) and experience very poor outcomes. Modifiable drivers of disparities need to be identified, but are not well-studied. Objective To describe racial-ethnic disparities among YA with T1D and identify drivers of glycemic disparity other than socioeconomic status (SES). Design Cross-sectional multicenter collection of patient and chart-reported variables, including SES, social determinants of health, and diabetes-specific factors, with comparison between non-Hispanic White, non-Hispanic Black, and Hispanic YA and multilevel modeling to identify variables that account for glycemic disparity apart from SES. Setting Six diabetes centers across the United States. Participants A total of 300 YA with T1D (18-28 years: 33% non-Hispanic White, 32% non-Hispanic Black, and 34% Hispanic). Main Outcome Racial-ethnic disparity in HbA1c levels. Results Non-Hispanic Black and Hispanic YA had lower SES, higher HbA1c levels, and much lower diabetes technology use than non-Hispanic White YA (P < 0.001). Non-Hispanic Black YA differed from Hispanic, reporting higher diabetes distress and lower self-management (P < 0.001). After accounting for SES, differences in HbA1c levels disappeared between non-Hispanic White and Hispanic YA, whereas they remained for non-Hispanic Black YA (+ 2.26% [24 mmol/mol], P < 0.001). Diabetes technology use, diabetes distress, and disease self-management accounted for a significant portion of the remaining non-Hispanic Black–White glycemic disparity. Conclusion This study demonstrated large racial-ethnic inequity in YA with T1D, especially among non-Hispanic Black participants. Our findings reveal key opportunities for clinicians to potentially mitigate glycemic disparity in minority YA by promoting diabetes technology use, connecting with social programs, and tailoring support for disease self-management and diabetes distress to account for social contextual factors.

Type 1 diabetes self‐management behaviors among emerging adults: Racial/ethnic differences

2020 ◽  
Vol 21 (6) ◽  
pp. 979-986
Author(s):  
Ashley M. Butler ◽  
Bridget E. Weller ◽  
Caryn R. R. Rodgers ◽  
Ashley E. Teasdale
Keyword(s):  
Type 1 Diabetes ◽  
Emerging Adults ◽  
Ethnic Differences ◽  
Self Management ◽  
Racial Ethnic ◽  
Management Behaviors

803-P: Modifiable Diabetes-Specific Factors and Glycemic Control in Economically Vulnerable and Racial/Ethnic Minority Young Adults with Type 1 Diabetes

Diabetes ◽  
2019 ◽  
Vol 68 (Supplement 1) ◽  
pp. 803-P
Author(s):  
SHIVANI AGARWAL ◽  
LAUREN KANAPKA ◽  
JENNIFER RAYMOND ◽  
ASHBY F. WALKER ◽  
ANDREA GERARD GONZALEZ ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Young Adults ◽  
Glycemic Control ◽  
Ethnic Minority ◽  
Specific Factors ◽  
Racial Ethnic

Health promotion challenges for young adults living with intellectual disability and type 1 diabetes

2021 ◽  
pp. 174462952110327
Author(s):  
Anne L Marks ◽  
Natasha Mahoney ◽  
Yu-Wei Chen ◽  
Reinie Cordier ◽  
Angus Buchanan ◽  
...  
Keyword(s):  
Health Promotion ◽  
Type 1 Diabetes ◽  
Young Adults ◽  
Intellectual Disability ◽  
Barriers And Facilitators ◽  
Self Management ◽  
Service Support ◽  
Health Support ◽  
Level Monitoring

Background: Self-management of type 1 diabetes mellitus (T1DM) can be challenging for people with intellectual disability. Often, parents provide health support due to lack of appropriate services outside the home. The study aim was to identify barriers and facilitators to T1DM self-management for young adults with intellectual disability and the implications for health promotion. Methods: Five male participants with intellectual disability, aged 17–26 years, and seven parents were interviewed between October 2017 and February 2019. Interview data were descriptively analysed. Findings: Two categories for barriers and facilitators were identified: 1) Diabetes self-management is complex (carbohydrate counting, blood glucose level monitoring, insulin therapy); 2) support for diabetes care (reliance on parents and carers, the National Disability Insurance Scheme, mainstream diabetes service support). Conclusions: Parents are critical for the support of people with intellectual disability and T1DM in the absence of disability staff with appropriate health skills.

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