Socioeconomic Inequality in Metabolic Control Among Children With Type 1 Diabetes: A Nationwide Longitudinal Study of 4,079 Danish Children
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Socioeconomic Inequality in Metabolic Control Among Children With Type 1 Diabetes : A Nationwide Longitudinal Study of 4,079 Danish Children. / Nielsen, Nick Fabrin; Gaulke, Amanda; Eriksen, Tine M.; Svensson, Jannet; Skipper, Niels.
I: Diabetes Care, Bind 42, Nr. 8, 01.08.2019, s. 1398-1405.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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TY - JOUR
T1 - Socioeconomic Inequality in Metabolic Control Among Children With Type 1 Diabetes
T2 - A Nationwide Longitudinal Study of 4,079 Danish Children
AU - Nielsen, Nick Fabrin
AU - Gaulke, Amanda
AU - Eriksen, Tine M.
AU - Svensson, Jannet
AU - Skipper, Niels
PY - 2019/8/1
Y1 - 2019/8/1
N2 - OBJECTIVE: To examine inequality in glycemic control by maternal educational level among children with type 1 diabetes in a setting with universal access to health care. RESEARCH DESIGN AND METHODS: This was a longitudinal nationwide study of 4,079 Danish children with type 1 diabetes between the years 2000 and 2013. Children were divided into four groups based on mothers' education prebirth (≤high school [n = 1,643], vocational or 2-year college [n = 1,548], bachelor's degree [n = 695], ≥master's degree [n = 193]). Means of socioeconomic and treatment characteristics were compared between groups. HbA1c and the number of daily glucose tests were compared repeatedly from onset until 5 years after onset across groups. HbA1c was compared across daily blood glucose testing frequency and groups. Linear regression was used to compare HbA1c across groups with and without adjustment for socioeconomic and treatment characteristics. RESULTS: Large differences in HbA1c across maternal education were found. The mean level of HbA1c during follow-up was 59.7 mmol/mol (7.6%) for children of mothers with ≥master's degrees and 68.7 mmol/mol (8.4%) for children of mothers with ≤high school (difference: 9.0 mmol/mol [95% CI 7.5, 10.6]; 0.8% [95% CI 0.7, 1.0]). The associations were attenuated but remained significant after adjustment. Observable characteristics explained 41.2% of the difference in HbA1c between children of mothers with ≤high school and mothers with ≥master's degree; 22.5% of the difference was explained by more frequent blood glucose monitoring among the children with the highly educated mothers. CONCLUSIONS: Family background is significantly related to outcomes for children with type 1 diabetes, even with universal access to health care.
AB - OBJECTIVE: To examine inequality in glycemic control by maternal educational level among children with type 1 diabetes in a setting with universal access to health care. RESEARCH DESIGN AND METHODS: This was a longitudinal nationwide study of 4,079 Danish children with type 1 diabetes between the years 2000 and 2013. Children were divided into four groups based on mothers' education prebirth (≤high school [n = 1,643], vocational or 2-year college [n = 1,548], bachelor's degree [n = 695], ≥master's degree [n = 193]). Means of socioeconomic and treatment characteristics were compared between groups. HbA1c and the number of daily glucose tests were compared repeatedly from onset until 5 years after onset across groups. HbA1c was compared across daily blood glucose testing frequency and groups. Linear regression was used to compare HbA1c across groups with and without adjustment for socioeconomic and treatment characteristics. RESULTS: Large differences in HbA1c across maternal education were found. The mean level of HbA1c during follow-up was 59.7 mmol/mol (7.6%) for children of mothers with ≥master's degrees and 68.7 mmol/mol (8.4%) for children of mothers with ≤high school (difference: 9.0 mmol/mol [95% CI 7.5, 10.6]; 0.8% [95% CI 0.7, 1.0]). The associations were attenuated but remained significant after adjustment. Observable characteristics explained 41.2% of the difference in HbA1c between children of mothers with ≤high school and mothers with ≥master's degree; 22.5% of the difference was explained by more frequent blood glucose monitoring among the children with the highly educated mothers. CONCLUSIONS: Family background is significantly related to outcomes for children with type 1 diabetes, even with universal access to health care.
U2 - 10.2337/dc19-0184
DO - 10.2337/dc19-0184
M3 - Journal article
C2 - 31123155
AN - SCOPUS:85070182632
VL - 42
SP - 1398
EP - 1405
JO - Diabetes Care
JF - Diabetes Care
SN - 0149-5992
IS - 8
ER -
ID: 226790577