Migration Status in Relation to Clinical Characteristics and Barriers to Care Among Youth with Diabetes in the US

• Type of Material: Article
• Authors: Lindsay M. Jaacks, University of North Carolina; Reena Oza-Frank, Ohio State University; Ralph D'Agostino, Wake Forest University; Lawrence M. Dolan, Cincinnati Children's Hospital Medical Center; Dana Dabelea, University of Colorado; Jean M. Lawrence, Kaiser Permanente Southern California; Catherine Pihoker, Seattle Children’s Hospital; M. Rebecca O'Connor, Seattle Children’s Hospital; Barbara Linder, National Institutes of Health; Giuseppina Imperatore, Centers for Disease Control and Prevention; Michael Seid, Cincinnati Children's Hospital Medical Center; K.M. Venkat Narayan, Emory University; Elizabeth J. Mayer-Davis, University of North Carolina
• Language: English
• Date: 2012-12-01
• Publisher: Springer (part of Springer Nature): Springer Open Choice Hybrid Journals
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2012, Springer Science Business Media, LLC (Outside the USA)
• Final Published Version (URL): http://dx.doi.org/10.1007/s10903-012-9617-3
• Title of Journal or Parent Work: Journal of Immigrant and Minority Health
• ISSN: 1557-1912
• Volume: 14
• Issue: 6
• Start Page: 949
• End Page: 958
• Grant/Funding Information: SEARCH for Diabetes in Youth is funded by the Centers for Disease Control and Prevention (PA numbers 00097, DP-05-069, and DP-10-001) and supported by the National Institute of Diabetes and Digestive and Kidney Diseases.; Site Contract Numbers: Kaiser Permanente Southern California (U48/CCU919219, U01 DP000246, and U18DP002714), University of Colorado Denver (U48/CCU819241-3, U01 DP000247, and U18DP000247-06A1), Kuakini Medical Center (U58CCU919256 and U01 DP000245), Children’s Hospital Medical Center (Cincinnati) (U48/CCU519239, U01 DP000248, and 1U18DP002709), University of North Carolina at Chapel Hill (U48/CCU419249, U01 DP000254, and U18DP002708-01), University of Washington School of Medicine (U58/CCU019235-4, U01 DP000244, and U18DP002710-01), Wake Forest University School of Medicine (U48/CCU919219, U01 DP000250, and 200-2010-35171).; The authors wish to acknowledge the involvement of General Clinical Research Centers (GCRC) at the South Carolina Clinical & Translational Research (SCTR) Institute, at the Medical University of South Carolina (NIH/NCRR Grant number UL1RR029882); Children’s Hospital and Regional Medical Center (Grant Number M01RR00037); Colorado Pediatric General Clinical Research Center (Grant Number M01 RR00069) and the Barbara Davis Center at the University of Colorado at Denver (DERC NIH P30 DK57516); and the Institutional Clinical and Translational Science Award (CTSA), NIH/NCRR at the University of Cincinnati (Grant Number 1UL1RR026314-01).
• Keywords: MELLITUS; Public, Environmental & Occupational Health; GLYCEMIC CONTROL; Youth; Migration; PREVALENCE; Life Sciences & Biomedicine; US; HEALTH; ACCULTURATION; IMMIGRANT; Diabetes; CHILDREN; SEARCH; Science & Technology; RISK-FACTORS; TYPE-1
• Research Categories: Health Sciences, Public Health

Abstract

Migration status and the accompanying diversity in culture, foods and family norms, may be an important consideration for practitioners providing individualized care to treat and prevent complications among youth with diabetes. Approximately 20 % of youth in the US have ≥1 foreign-born parent. However, the proportion and characteristics of youth with diabetes and ≥1 foreignborn parent have yet to be described. Study participants (n = 3,086) were from SEARCH for Diabetes in Youth, a prospective multi-center study in the US. Primary outcomes of interest included HbA1c, body mass index and barriers to care. Multivariable analyses were carried out using logistic regression and analysis of covariance. Approximately 17 % of participants with type 1 diabetes (T1D) and 22 % with type 2 diabetes (T2D) had ≥1 foreign-born parent. Youth with T1D and ≥1 foreign-born parent were less likely to have poor glycemic control [adjusted odds ratio (OR) (95 % confidence interval): 0.70(0.53, 0.94)]. Among youth with T2D, those with ≥1 foreign-born parent had lower odds of obesity [adjusted OR (95 % CI):0.35 (0.17, 0.70)]. This is the first study to estimate the proportion and characteristics of youth with diabetes exposed to migration in the US. Research into potential mechanisms underlying the observed protective effects is warranted. © Springer Science+Business Media, LLC (Outside the USA) 2012.