Health markers, depressive symptoms, and community deprivation in a type 2 diabetes multidisciplinary care clinic for youth.

Clinical Diabetes and Endocrinology Pub Date : 2024-07-17 DOI:10.1186/s40842-024-00180-x

Carolina M Bejarano, Sanita Ley, Nisha Krishnan, Sarah Orkin, Nancy A Crimmins, Lisa Schaaf, Amy S Shah

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Abstract

Introduction: Type 2 diabetes disproportionately affects non-Hispanic/Latino Black and Hispanic/Latino youth. The purpose of this study was to examine whether differences in metabolic risk factors and depressive symptoms exist by race/ethnicity and socioeconomic deprivation and whether these impact clinic attendance and health markers over 1 year in a multidisciplinary type 2 diabetes clinic for youth.

Methods: This study was a retrospective chart review of 54 youth with type 2 diabetes who had both an initial and follow-up visit. Demographic information, metabolic health markers [body mass index (BMI), hemoglobin A1C, liver enzymes, lipid panel, and urine microalbumin], depressive symptoms, and clinic attendance data were obtained from the medical record. Patient address was geocoded to the census tract level to calculate community socioeconomic deprivation.

Results: Liver enzymes (ALT and AST) were significantly higher in patients identifying as Hispanic/Latino (ALT M = 97.0 ± 40.6, AST M = 53.6 ± 21.4) and lowest in patients identifying as non-Hispanic/Latino Black (ALT M = 23.1 ± 11.3, F = 10.6 p < .001; AST M = 23.1 ± 11.4, F = 8.1; p < .001) at initial visit. From initial visit to follow-up, there were significant improvements in ALT (F = 13.43, p < .001), AST (F = 6.58, p < .05), and BMIz (F = 18.39, p < .001). Patients identifying as Black or Hispanic showed an increase in depressive symptoms over time, while patients identifying as non-Hispanic White showed a decrease (F = 11.08; p < .05). Unexpectedly, patients living in areas with higher socioeconomic deprivation showed a decrease in hemoglobin A1C over time, while patients living in lower socioeconomic deprivation showed an increase (F = 5.15, p < .05).

Conclusions: Differences exist in metabolic health parameters by race/ethnicity and by socioeconomic deprivation. Multidisciplinary care for youth with type 2 diabetes needs to consider and work to address the systems of inequity experienced by patients that drive disparities in health outcomes.

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青少年 2 型糖尿病多学科护理诊所的健康指标、抑郁症状和社区贫困状况。

导言：2 型糖尿病对非西班牙裔/拉美裔黑人和西班牙裔/拉美裔青少年的影响尤为严重。本研究旨在探讨不同种族/族裔和社会经济贫困程度的青少年在代谢风险因素和抑郁症状方面是否存在差异，以及这些因素是否会影响青少年多学科 2 型糖尿病门诊一年内的就诊率和健康指标：这项研究是一项回顾性病历审查，涉及 54 名 2 型糖尿病青少年患者，他们都接受了初诊和复诊。研究人员从病历中获取了患者的人口统计学信息、代谢健康指标（体重指数 (BMI)、血红蛋白 A1C、肝酶、血脂组合和尿微量白蛋白）、抑郁症状和就诊数据。对患者地址进行地理编码，以人口普查区为单位计算社区社会经济贫困程度：结果：肝酶（ALT 和 AST）在西班牙裔/拉美裔患者中明显较高（ALT M = 97.0 ± 40.6，AST M = 53.6 ± 21.4），而在非西班牙裔/拉美裔黑人患者中最低（ALT M = 23.1 ± 11.3，F = 10.6 p 结论：新陈代谢在不同人群中存在差异：不同种族/族裔和社会经济贫困程度的代谢健康参数存在差异。针对 2 型糖尿病青少年患者的多学科治疗需要考虑并努力解决患者所经历的不公平系统，这些不公平系统导致了健康结果的差异。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical Diabetes and Endocrinology

自引率

0.00%

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审稿时长

8 weeks

期刊介绍： Clinical Diabetes and Endocrinology is an open access journal publishing within the field of diabetes and endocrine disease. The journal aims to provide a widely available resource for people working within the field of diabetes and endocrinology, in order to improve the care of people affected by these conditions. The audience includes, but is not limited to, physicians, researchers, nurses, nutritionists, pharmacists, podiatrists, psychologists, epidemiologists, exercise physiologists and health care researchers. Research articles include patient-based research (clinical trials, clinical studies, and others), translational research (translation of basic science to clinical practice, translation of clinical practice to policy and others), as well as epidemiology and health care research. Clinical articles include case reports, case seminars, consensus statements, clinical practice guidelines and evidence-based medicine. Only articles considered to contribute new knowledge to the field will be considered for publication.