Ethnic disparities in HbA1c and hypoglycemia among youth with type 1 diabetes: beyond access to technology, social deprivation and mean blood glucose
Authors' conclusion
CYP from Black ethnic backgrounds have a higher HbA1c compared with their South Asian and White counterparts which is clinically significant and independent of MBG, potentially contributing to increased complications risk. Additionally, the Black group experienced a higher incidence of hypoglycemia, possibly due to a treat-to-HbA1c target approach.
Study context
- Population
- Children and young people (CYP) with T1D who received structured education in continuous glucose monitoring (CGM) use, tertiary centre; HbA1c paired with 90-day CGM data
- Participants
- 168 participants
- Exposure
- Black vs South Asian vs White ethnicity
- Blackn = 28
- South Asiann = 61
- Whiten = 79reference
- Outcome
- HbA1c ethnic disparity after accounting for MBG, socioeconomic status (SES) (IMD) and access to technology
Methodological detailssingle tertiary centre
- Single tertiary centre
Main finding
As reported in the abstract
Adjusted HbA1c
P < 0.001
- Mean blood glucose (MBG) (p<0.0001), ethnicity (p<0.0001), age (p<0.001), diabetes duration (p<0.01) and percent sensor use (PSU) (p<0.05) accounted for variability in HbA1c
- 81%
Observational data: associations, not effects.
Further findings
Baseline characteristics (age, MBG, TIR 3.9-10.0 mmol/L, diabetes duration, gender, MDI vs CSII, PSU)
- No differences between groups
Safety
| Outcome | P value |
|---|---|
| Hypoglycaemia (<3.9 and <3.0 mmol/L)Black vs South Asian and White · more hypoglycaemia in Black · multiple variable analysis | P < 0.05 |
Original publication
Ethnic disparities in HbA1c and hypoglycemia among youth with type 1 diabetes: beyond access to technology, social deprivation and mean blood glucose. BMJ Open Diabetes Res Care. Published 25 January 2025. doi:10.
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