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Self-reported Social Class, Self-management Behaviors, and the Effect of Diabetes Mellitus in Urban, Minority Young People and Their Families
Rebecca Lipton, PhD;
Melinda Drum, PhD;
Deborah Burnet, MD;
Maureen Mencarini, MS;
Andrew Cooper;
Barry Rich, MD
Arch Pediatr Adolesc Med. 2003;157:919-925.
Objective To document social factors, diabetes mellitus (DM) self-management, and the effect of the disease among children with DM residing in Chicago, Ill.
Methods Patients were ascertained for a population-based study of childhood-onset DM (ages, 0-17 years). Families and patients (N = 288) were interviewed about health services use, sociodemographics, self-management behaviors, and other characteristics, a mean of 6.1 years after diagnosis. Univariate and multivariate analyses were conducted.
Results Most patients were non-Hispanic black (68.4%) or Hispanic (28.5%). Overall, 59.8% of the respondents received Medicaid or had no health insurance at the time of disease onset, including 61.7% of non-Hispanic black patients and 59.2% of Hispanic patients. Of the entire group, 61.5% reported that having DM had affected their family life in some way, with 14.9% reporting difficulty in obtaining child care and 18.4% reporting an effect on the parent and/or guardian's job. Having DM negatively affected the personal lives of 33.7% of the young people, with 13.9% having been excluded from sports activities, and 16.8% having had difficulty obtaining insurance. Among the 64 patients who were aged 20 years or older when interviewed, 21.0% had been denied employment because of their DM. The level of blood glucose was measured less than once daily by 8.8% of the respondents, while 12.4% had never been given a dilated ophthalmologic examination or had not been examined within the past year. Fully 30.6% of those aged 20 years or older smoked cigarettes. There were few ethnic differences in these characteristics.
Conclusion We conclude that DM has had a significant effect in this group of primarily African American and Hispanic young people who have a chronic illness.
From the Departments of Pediatrics (Drs Lipton, Burnet, Mencarini, and Rich and Mr Cooper), Medicine (Dr Burnet), and Health Studies (Drs Lipton and Drum), University of Chicago, Chicago, Ill.
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Self-Management Behaviors, Racial Disparities, and Glycemic Control Among Adolescents With Type 2 Diabetes
Rothman et al.
Pediatrics 2008;121:e912-e919.
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