Because minority adults with diabetes have significantly greater morbidity and mortality than whites and higher incidence of diabetic end-stage renal disease, it is important to be concerned with the health status of minority children with diabetes. Although not conclusive, research indicates that metabolic control is an important factor in diabetes management and prevention of complications. Recent studies suggest that African-American diabetic children are in worse metabolic control than whites. Little is known, however, about Hispanic youths with diabetes. Regimen compliance is assumed to be an important determinant of metabolic control, yet studies show that compliance is generally poor. Little is known, however, about factors affecting compliance in minority youths. Furthermore, although research indicates that compliance can be improved with behavioral interventions, findings are limited by the small numbers of patients treated, the lack of long-term follow-up, the modest effects on metabolic control, and the lack of studies with minority inner-city youths. There is a need for studies of regimen compliance and metabolic control among low- SES minority youths that can identify the special needs of such populations, including cultural factors that may impede or facilitate behavioral interventions.
The Specific Aims of this research are: 1) to determine the demographic, psychosocial, and behavioral factors that contribute to metabolic control problems of African-American and Hispanic youths with Type I diabetes; 2) to identify the determinants of regimen compliance problems; and 3) to utilize the results of these studies to guide the development of interventions to improve compliance and metabolic control of minority youths. The multicultural setting of the University of Miami is advantageous for study of these issues, with over 200 predominantly low-SES African-American and Hispanic diabetic youths followed in the outpatient clinics. We will recruit 120 10-17 year old youths (40 African-American, 40 Hispanic, 40 white) and conduct assessments of demographic and psychosocial factors, regimen compliance, and metabolic control using standardized measures. The results of this research will contribute toward a better understanding of factors affecting regimen compliance and metabolic control of young minority patients with diabetes, and are especially pertinent to the development of compliance intervention programs for minority youths.
| Delamater, A M; Shaw, K H; Applegate, E B et al. (1999) Risk for metabolic control problems in minority youth with diabetes. Diabetes Care 22:700-5 |
