Tuesday, February 17, 2015

Racial-Ethnic Disparities in Managing Children with Type 1 Diabetes: Do They Exist?

     Everyone would agree that the care they provide to one child versus another shouldn't differ on the basis of race or ethnicity—but unfortunately, disparities in the management of diabetes do exist on that basis—as per some important findings contained in a study being released this week by Willi et al. (doi:10.1542/peds.2014-1774). 
The authors looked at disparities as documented in a national type 1 diabetes clinical registry for more than 10,000 children and teens between 1 year and 18 years of age with the disease.  Even after adjusting for socioeconomic status, differences existed in insulin treatment methods and treatment outcomes. 
So why does this happen—and just what are the disparities noted?  Are results due to different management strategies or perhaps it is because the genetics of the disease differs by race and ethnicity resulting in different achievable levels of hemoglobin A1C and other diabetic outcome measures. 
The authors offer some insight into the findings they have analyzed, but we have also asked diabetologist Dr. Stuart Chalew (doi: 10.1542/peds.2014-4136) to share his perspective on this study via a commentary released simultaneously.  Both the study and commentary are thought provoking, and we hope will generate some conversation from our readers as well via a response in the comments below, an e-letter or comment on our Facebook or Twitter pages.  Do you agree with the findings relative to your own practice?  We look forward to your comments as to whether the disparities noted are ones we can improve upon.

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