Contribution of income to self-management and health outcomes in pediatric type 1 diabetes

Pediatr Diabetes. 2016 Mar;17(2):120-6. doi: 10.1111/pedi.12240. Epub 2014 Dec 29.

Abstract

Low income has been established as a risk factor for poorer outcomes in youth with type 1 diabetes; however, the effect of moderate income has not been studied. The purpose of this secondary analysis of baseline data from a multi-site study was to compare glycemic control, self-management, and psychosocial outcomes [depression, stress, and quality of life (QOL)] at different income levels in adolescents with type 1 diabetes. Youth (n = 320, mean age = 12.3 + 1.1, 55% female, 64% white, mean A1C = 8.3 ± 1.4) completed established self-management and psychosocial measures. A1C levels were collected from medical records. Caregivers reported annual family income, categorized as high (>$80K), moderate ($40-80K), or low (<$40K). Youth from high-income families had significantly lower A1C (mean = 7.9 ± 1.2) than those from the moderate-income group (8.6 ± 1.7, p < 0.001) or the low-income group (mean A1C = 8.6 ± 1.5, p = 0.003). Youth from the high-income group reported significantly better diabetes problem solving and more self-management goals than those from the moderate- or low-income groups (both p < 0.01). Youth from the high-income group also reported significantly fewer symptoms of depression, lower levels of perceived stress, and better QOL than those in the moderate or low-income groups (all p < 0.05). Multivariate linear regression models were used to test psychological and behavioral predictors of A1C and QOL. Parents' education status (p < 0.05) and self-management activities (p < 0.01) were significant predictors of hemoglobin A1c, while income (p < 0.01) and self-management activities (p < 0.05) were significant predictors of QOL.

Keywords: diabetes mellitus (type 1); income; juvenile-onset diabetes; pediatrics; psychosocial support systems.

Publication types

  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adaptation, Psychological
  • Adolescent
  • Blood Glucose / analysis
  • Child
  • Diabetes Mellitus, Type 1 / blood
  • Diabetes Mellitus, Type 1 / diagnosis*
  • Diabetes Mellitus, Type 1 / economics
  • Diabetes Mellitus, Type 1 / epidemiology*
  • Female
  • Humans
  • Income / statistics & numerical data*
  • Male
  • Patient Outcome Assessment
  • Prognosis
  • Quality of Life
  • Self Care / economics*
  • Self Care / psychology
  • Self Care / statistics & numerical data
  • Surveys and Questionnaires

Substances

  • Blood Glucose