Document Type : original article
Authors
- Neda Mostofizadeh 1
- Elham Hashemi 2
- Noushin Rostampour 1
- Silva Hovsepian 3
- Sepideh Tahermaram 4
- Roya Riahi 5
- Mahin Hashemipour 6
1 Metabolic Liver Disease Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
2 Endocrine and Metabolism Research Center, Isfahan University of Medical Sciences, Isfahan, IRAN
3 Isfahan University of Medical sciences
4 School of Medicine, Isfahan University of Medical Sciences
5 Department of Epidemiology and Biostatistics, Isfahan University of Medical Sciences, Isfahan, Iran.
6 Metabolic Liver Disease Research Center, Endocrine and Metabolism Research Center, Isfahan University of Medical Sciences, Isfahan, IRAN
Abstract
Background: Considering the higher rate of suboptimal glycemic control in type 1 diabetic(T1DM) children and the increasing trend of T1DM in our community and worldwide and the role of glycemic control in preventing complications of the patients along with the lack of studies regarding the role of family socioeconomic status (SES) and its indicators in our community, we aimed to investigate the association between family SES and glycemic control in children and adolescents with T1DM in Isfahan, Iran.
Methods: In this cross sectional study, T1DM patients aged 1-18 years were enrolled. The patients were classified into two groups, with and without appropriate glycemic control, based on the mean of the last three HbA1c mean levels. The characteristics of the patients in different categories of family SES were compared and the associations were evaluated.
Results: In this study 312 children with T1DM (156 with and without optimal glycemic control) and their families were evaluated. Low, moderate and high family SES was presented in 20.4%, 71.6% and 8% of the total population. Frequency of low SES was significantly higher in patients with poor glycemic control (P<0.001).There was significant positive association between family SES and appropriate glycemic control (P<001, OR=6.63, CI95%; 2.2-19.3).
Conclusion: Our findings indicated that in accordance with previous studies, the SES of Iranian families, assessed by multiple factors of parents’ and families’ characteristics, is associated with glycemic control of children with T1DM. These findings would be helpful for health care professionals to design more comprehensive programs based on the SES of the patients' families as well as healthcare policymakers to properly allocate resources in order to obtain more appropriate glycemic control for all patients with T1DM.
Keywords
- Norris JM, Johnson RK, Stene LC. Type 1 diabetes-Early life origins and changing epidemiology. The Lancet Diabetes & endocrinology. 2020 Mar 1; 8(3):226-38.
- Gregory GA, Robinson TI, Linklater SE, Wang F, Colagiuri S, de Beaufort C, Donaghue KC, Magliano DJ, Maniam J, Orchard TJ, Rai P. Global incidence, prevalence, and mortality of type 1 diabetes in 2021 with projection to 2040: a modeling study. The Lancet Diabetes & Endocrinology. 2022; 10(10):741-60.
- Green A, Hede SM, Patterson CC, Wild SH, Imperatore G, Roglic G, Beran D. Type 1 diabetes in 2017: global estimates of incident and prevalent cases in children and adults. Diabetologia. 2021; 64(12):2741-50.
- DiMeglio LA, Evans-Molina C, Oram RA. Type 1 diabetes. The Lancet. 2018; 391(10138): 2449-62.
- Syed FZ. Type 1 Diabetes Mellitus. Ann Intern Med. 2022;175(3):ITC33-ITC48.
- Piona C, Ventrici C, Marcovecchio L, Chiarelli F, Maffeis C, Bonfanti R, Rabbone I. Long-term complications of type 1 diabetes: what do we know and what do we need to understand? Minerva Pediatr (Torino). 2021; 73(6):504-522.
- Petitti DB, Klingensmith GJ, Bell RA, et al. Glycemic control in youth with diabetes: the SEARCH for diabetes in Youth Study. J Pediatr. 2009; 155(5):668–72.e1–3.
- Hashemipour M, Hovsepian S, Mozafarian N, Motaghi Z, Izadkhah E, Maracy MR. Factors related to glycemic control in children and adolescents with type 1 diabetes mellitus in Isfahan, Iran. Journal of Diabetes & Metabolic Disorders. 2021; 20(2):1281-8.
- Mönkemöller K, Müller‐Godeffroy E, Lilienthal E, Heidtmann B, Becker M, Feldhahn L, Freff M, Hilgard D, Krone B, Papsch M, Schumacher A. The association between socio‐economic status and diabetes care and outcome in children with diabetes type 1 in Germany: The DIAS study (diabetes and social disparities). Pediatric diabetes. 2019; 20(5):637-44.
- Dumrisilp T, Supornsilchai V, Wacharasindhu S, Aroonparkmongkol S, Sahakit Rungruang T. Factors associated with glycemic control in children and adolescents with type 1 diabetes mellitus at a tertiary-care center in Thailand: a retrospective observational study. Asian Biomedicine. 2017; 11(6):443-50.
- Lindner LME, Rathmann W, Rosenbauer J. Inequalities in glycaemic control, hypoglycemia and diabetic ketoacidosis according to socio-economic status and area-level deprivation in Type 1 diabetes mellitus: a systematic review. Diabet Med. 2018; 35(1):12–32.
- Borschuk AP, Everhart RS. Health disparities among youth with type 1 diabetes: A systematic review of the current literature. Fam Syst Health. 2015; 33(3):297-313.
- Improving Care and Promoting Health in Populations:Standards of Medical Care in Diabetes-2018.Diabetes Care. 2018; 41(Suppl 1):S7–S12.
- Willi SM, Miller KM, DiMeglio LA, et al. Racial-ethnic disparities in management and outcomes among children with type 1 diabetes. Pediatrics. 2015; 135(3):424–434. 15. Kelishadi R, Ardalan G, Qorbani M, Ataie-Jafari A, Bahreynian M, Taslimi Taslimi, Motlagh ME. et al. Methodology and early findings of the fourth survey of childhood and adolescence surveillance and prevention of adult non-communicable disease in Iran: The CASPIAN-IV Study. Int J Prev Med. 2013; 4(12):1451–60.
- Majidi S, Wadhwa R, Bishop FK, et al. The effect of insurance status and parental education on glycemic control and cardiovascular disease risk profile in youth with Type 1 Diabetes. J Diabetes Metab Disord. 2014; 13(1):59.
- Al-Odayani AN, Al Sharqi OZ, Ahmad AMK, Khalaf Ahmad AM, Al-Borie HM, Qattan AMN.Children’s glycemic control: mother’s knowledge and socioeconomic status. Glob J Health Sci.2013; 5(6):214–226.
- Scott A, Chambers D, Goyder E, O’Cathain A. Socioeconomic inequalities in mortality, morbidity and diabetes management for adults with type 1 diabetes: A systematic review. PLoS One.2017; 12(5):e0177210.
- Fegan-Bohm K, Minard CG, Anderson BJ, Butler AM, Titus C, Weissberg-Benchell J, Hilliard ME. Diabetes distress and HbA1c in racially/ethnically and socioeconomically diverse youth with type 1 diabetes. Pediatr Diabetes. 2020; 21(7):1362-1369.
- Sutherland MW, Ma X, Reboussin BA, Mendoza JA, Bell BA, Kahkoska AR, Sauder KA, Lawrence JM, Pihoker C, Liese AD. Socioeconomic position is associated with glycemic control in youth and young adults with type 1 diabetes. Pediatric diabetes. 2020; 21(8):1412-20.
- Nielsen NF, Gaulke A, Eriksen TM, Svensson J, Skipper N. Socioeconomic inequality in metabolic control among children with type 1 diabetes: a nationwide longitudinal study of 4,079 Danish children. Diabetes care. 2019; 42(8):1398-405.
- Andrade CJDN, Alves CAD. Influence of socioeconomic and psychological factors in glycemic control in young children with type 1 diabetes mellitus. J Pediatr (Rio J). 2019; 95(1): 48-53.
- AlAgha MA, Majdi WM, Aljefri HM, Ali MA, Alagha AE, Abd-Elhameed IA. Effect of parents’ educational level and occupational status on child glycemic control. J Pat Care. 2017; 3(130):2.
- Alassaf A, Odeh R, Gharaibeh L, Ibrahim S, Ajlouni K. Impact of socioeconomic characteristics on metabolic control in children with type 1 diabetes in a developing country. Journal of Clinical Research in Pediatric Endocrinology. 2019; 11(4):358.
- Gesuita R, Skrami E, Bonfanti R, Cipriano P, Ferrito L, Frongia P, Iafusco D, Iannilli A, Lombardo F, Mozzillo E, Paleari R. The role of socio‐economic and clinical factors on HbA1c in children and adolescents with type 1 diabetes: an Italian multicentre survey. Pediatric diabetes. 2017; 18(3):241-8.
- Liese AD, Reboussin BA, Kahkoska AR, Frongillo EA, Malik FS, Imperatore G, Saydah S, Bellatorre A, Lawrence JM, Dabelea D, Mendoza JA. Inequalities in Glycemic Control in Youth with Type 1 Diabetes over Time: Intersectionality between Socioeconomic Position and Race and Ethnicity. Ann Behav Med. 2022; 56(5):461-471.
)