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• W2890877471 endingPage "e181851" @default.
• W2890877471 startingPage "e181851" @default.
• W2890877471 abstract "<h3>Importance</h3> Health disparities in the clinical presentation and outcomes among youth with type 1 diabetes exist. Long-term glycemic control patterns in racially/ethnically diverse youth are not well described. <h3>Objectives</h3> To model common trajectories of hemoglobin A_1c(HbA_1c) among youth with type 1 diabetes and test how trajectory group membership varies by race/ethnicity. <h3>Design, Setting, and Participants</h3> Longitudinal cohort study conducted in 5 US locations. The analysis included data from 1313 youths (aged <20 years) newly diagnosed in 2002 through 2005 with type 1 diabetes in the SEARCH for Diabetes in Youth study (mean [SD] age at diabetes onset, 8.9 [4.2] years) who had 3 or more HbA_1cstudy measures during 6.1 to 13.3 years of follow-up. Data were analyzed in 2017. <h3>Exposures</h3> Self-reported race/ethnicity. <h3>Main Outcomes and Measures</h3> Hemoglobin A_1ctrajectories identified through group-based trajectory modeling over a mean (SD) of 9.0 (1.4) years of diabetes duration. Multinomial models studied the association of race/ethnicity with HbA_1ctrajectory group membership, adjusting for demographic characteristics, clinical factors, and socioeconomic position. <h3>Results</h3> The final study sample of 1313 patients was 49.3% female (647 patients) with mean (SD) age 9.7 (4.3) years and mean (SD) disease duration of 9.2 (6.3) months at baseline. The racial/ethnic composition was 77.0% non-Hispanic white (1011 patients), 10.7% Hispanic (140 patients), 9.8% non-Hispanic black (128 patients), and 2.6% other race/ethnicity (34 patients). Three HbA_1ctrajectories were identified: group 1, low baseline and mild increases (50.7% [666 patients]); group 2, moderate baseline and moderate increases (41.7% [548 patients]); and group 3, moderate baseline and major increases (7.5% [99 patients]). Group 3 was composed of 47.5% nonwhite youths (47 patients). Non-Hispanic black youth had 7.98 higher unadjusted odds (95% CI, 4.42-14.38) than non-Hispanic white youth of being in the highest HbA_1ctrajectory group relative to the lowest HbA_1ctrajectory group; the association remained significant after full adjustment (adjusted odds ratio of non-Hispanic black race in group 3 vs group 1, 4.54; 95% CI, 2.08-9.89). Hispanic youth had 3.29 higher unadjusted odds (95% CI, 1.78-6.08) than non-Hispanic white youth of being in the highest HbA_1ctrajectory group relative to the lowest HbA_1ctrajectory group; the association remained significant after adjustment (adjusted odds ratio of Hispanic ethnicity in group 3 vs group 1, 2.24; 95% CI, 1.02-4.92). In stratified analyses, the adjusted odds of nonwhite membership in the highest HbA_1ctrajectory remained significant among male patients and youth diagnosed at age 9 years or younger, but not female patients and youth who were older than 9 years when they were diagnosed (<i>P</i>for interaction = .04 [sex] and .02 [age at diagnosis]). <h3>Conclusions and Relevance</h3> There are racial/ethnic differences in long-term glycemic control among youth with type 1 diabetes, particularly among nonwhite male patients and nonwhite youth diagnosed earlier in life." @default.
• W2890877471 created "2018-09-27" @default.
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• W2890877471 date "2018-09-07" @default.
• W2890877471 modified "2023-10-18" @default.
• W2890877471 title "Association of Race and Ethnicity With Glycemic Control and Hemoglobin A_1c Levels in Youth With Type 1 Diabetes" @default.
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• W2890877471 doi "https://doi.org/10.1001/jamanetworkopen.2018.1851" @default.
• W2890877471 hasPubMedCentralId "https://www.ncbi.nlm.nih.gov/pmc/articles/6203341" @default.
• W2890877471 hasPubMedId "https://pubmed.ncbi.nlm.nih.gov/30370425" @default.
• W2890877471 hasPublicationYear "2018" @default.

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