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Self-management behaviors, racial disparities, and glycemic control among adolescents with type 2 diabetes.
Pediatrics. 2008 Apr; 121(4):e912-9.Ped

Abstract

OBJECTIVE

Type 2 diabetes is a growing problem among adolescents, but little is known about self-management behaviors in this population. Our aim was to examine self-management behaviors and glycemic control among adolescents with type 2 diabetes.

METHODS

From 2003 to 2005, a telephone survey of adolescents with type 2 diabetes was performed. Chart review obtained most recent glycated hemoglobin and clinical characteristics. Analyses compared patient characteristics and self-management behaviors to recent glycated hemoglobin levels.

RESULTS

Of 139 patients contacted, 103 (74%) completed the study. The mean age was 15.4 years: 69% were girls, 47% were white, and 46% were black. Mean glycated hemoglobin was 7.7%, and the average duration of diabetes was 2.0 years. More than 80% of patients reported > or = 75% medication compliance, and 59% monitored blood glucose > 2 times daily. However, patients reported frequent episodes of overeating, drinking sugary drinks, and eating fast food. More than 70% of patients reported exercising > or = 2 times a week, but 68% reported watching > or = 2 hours of television daily. Nonwhite patients had higher glycated hemoglobin and hospitalizations per year compared with white patients. In multivariable analyses, nonwhite race remained significantly associated with higher glycated hemoglobin even after adjusting for age, gender, BMI, insurance status, and other factors. Nonwhite patients were more likely to watch > or = 2 hours of television per day (78% vs 56%), to report exercising < or = 1 time per week (35% vs 21%), and to drink > or = 1 sugary drink daily (27% vs 13%).

CONCLUSION

Although patients reported good medication and monitoring adherence, they also reported poor diet and exercise habits and multiple barriers. Nonwhite race was significantly associated with poorer glycemic control even after adjusting for covariates. This may, in part, be related to disparities in lifestyle behaviors. Additional studies are indicated to further assess self-management behaviors and potential racial disparities in adolescents with type 2 diabetes.

Authors+Show Affiliations

Vanderbilt Center for Health Services Research, Suite 6000 Medical Center East, Nashville, TN 37232-8300, USA. russell.rothman@vanderbilt.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural

Language

eng

PubMed ID

18381520

Citation

Rothman, Russell L., et al. "Self-management Behaviors, Racial Disparities, and Glycemic Control Among Adolescents With Type 2 Diabetes." Pediatrics, vol. 121, no. 4, 2008, pp. e912-9.
Rothman RL, Mulvaney S, Elasy TA, et al. Self-management behaviors, racial disparities, and glycemic control among adolescents with type 2 diabetes. Pediatrics. 2008;121(4):e912-9.
Rothman, R. L., Mulvaney, S., Elasy, T. A., VanderWoude, A., Gebretsadik, T., Shintani, A., Potter, A., Russell, W. E., & Schlundt, D. (2008). Self-management behaviors, racial disparities, and glycemic control among adolescents with type 2 diabetes. Pediatrics, 121(4), e912-9. https://doi.org/10.1542/peds.2007-1484
Rothman RL, et al. Self-management Behaviors, Racial Disparities, and Glycemic Control Among Adolescents With Type 2 Diabetes. Pediatrics. 2008;121(4):e912-9. PubMed PMID: 18381520.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Self-management behaviors, racial disparities, and glycemic control among adolescents with type 2 diabetes. AU - Rothman,Russell L, AU - Mulvaney,Shelagh, AU - Elasy,Tom A, AU - VanderWoude,Ann, AU - Gebretsadik,Tebeb, AU - Shintani,Ayumi, AU - Potter,Amy, AU - Russell,William E, AU - Schlundt,David, PY - 2008/4/3/pubmed PY - 2008/5/1/medline PY - 2008/4/3/entrez SP - e912 EP - 9 JF - Pediatrics JO - Pediatrics VL - 121 IS - 4 N2 - OBJECTIVE: Type 2 diabetes is a growing problem among adolescents, but little is known about self-management behaviors in this population. Our aim was to examine self-management behaviors and glycemic control among adolescents with type 2 diabetes. METHODS: From 2003 to 2005, a telephone survey of adolescents with type 2 diabetes was performed. Chart review obtained most recent glycated hemoglobin and clinical characteristics. Analyses compared patient characteristics and self-management behaviors to recent glycated hemoglobin levels. RESULTS: Of 139 patients contacted, 103 (74%) completed the study. The mean age was 15.4 years: 69% were girls, 47% were white, and 46% were black. Mean glycated hemoglobin was 7.7%, and the average duration of diabetes was 2.0 years. More than 80% of patients reported > or = 75% medication compliance, and 59% monitored blood glucose > 2 times daily. However, patients reported frequent episodes of overeating, drinking sugary drinks, and eating fast food. More than 70% of patients reported exercising > or = 2 times a week, but 68% reported watching > or = 2 hours of television daily. Nonwhite patients had higher glycated hemoglobin and hospitalizations per year compared with white patients. In multivariable analyses, nonwhite race remained significantly associated with higher glycated hemoglobin even after adjusting for age, gender, BMI, insurance status, and other factors. Nonwhite patients were more likely to watch > or = 2 hours of television per day (78% vs 56%), to report exercising < or = 1 time per week (35% vs 21%), and to drink > or = 1 sugary drink daily (27% vs 13%). CONCLUSION: Although patients reported good medication and monitoring adherence, they also reported poor diet and exercise habits and multiple barriers. Nonwhite race was significantly associated with poorer glycemic control even after adjusting for covariates. This may, in part, be related to disparities in lifestyle behaviors. Additional studies are indicated to further assess self-management behaviors and potential racial disparities in adolescents with type 2 diabetes. SN - 1098-4275 UR - https://www.unboundmedicine.com/medline/citation/18381520/Self_management_behaviors_racial_disparities_and_glycemic_control_among_adolescents_with_type_2_diabetes_ L2 - http://pediatrics.aappublications.org/cgi/pmidlookup?view=long&amp;pmid=18381520 DB - PRIME DP - Unbound Medicine ER -