Racial and ethnic differences among children with new‐onset autoimmune Type 1 diabetes
Aim To compare demographic and clinical characteristics among children from ethnic minorities and non‐Hispanic white children with new‐onset autoimmune Type 1 diabetes. Methods We analysed a single‐centre series of 712 children with new‐onset autoimmune Type 1 diabetes between January 2008 and March...
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| Veröffentlicht in: | Diabetic medicine 2017-10, Vol.34 (10), p.1435-1439 |
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| creator | Gandhi, K. Tosur, M. Schaub, R. Haymond, M. W. Redondo, M. J. |
| description | Aim
To compare demographic and clinical characteristics among children from ethnic minorities and non‐Hispanic white children with new‐onset autoimmune Type 1 diabetes.
Methods
We analysed a single‐centre series of 712 children with new‐onset autoimmune Type 1 diabetes between January 2008 and March 2011. The median (range) age was 9.7 (0.3–18.1) years, the mean (sd) BMI percentile was 69.7 (25.4) and 48.3% of the cohort were girls. The cohort comprised 57.3% non‐Hispanic white, 20.5% Hispanic and 14.8% African‐American children, and 7.4% were of other, mixed or unknown race.
Results
The Hispanic subgroup, compared with non‐Hispanic white subgroup, had a higher mean (sd) C‐peptide level [0.82 (1.62) vs 0.55 (0.47) ng/ml; P=0.004), and a greater proportion of children with elevated BMI (overweight or obesity; 49.6% vs 32.5%; P |
| doi_str_mv | 10.1111/dme.13408 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1911201291</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1911201291</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3888-f99572f1b5ca2678063579e35d87ebbeee54c4e3e3ba4b04209b696a2c65c22d3</originalsourceid><addsrcrecordid>eNp10MtKAzEUBuAgiq3VhS8gATe6mDa3uWQptV6gIkgFd0Mmc8ZGZjJ1MkPpzkfwGX0S04suBLM5EL78nPwInVIypP6M8gqGlAuS7KE-FZEIQiHpPuqTWLCAk5j20JFzb4RQJrk8RD2WRCySIumjlyeljSqxsjmGdm6NxrkpCmjAanBYVbV9xXpuytzf4KVp59jC8uvjs7YOWqy6tjZV1VnAs9UCMPWvVQYtuGN0UKjSwcluDtDzzWQ2vgumj7f346tpoHmSJEEhZRizgmahViyKExLxMJbAwzyJIcsAIBRaAAeeKZERwYjMIhkppqNQM5bzAbrY5i6a-r0D16aVcRrKUlmoO5dSSSlbf5x6ev6HvtVdY_12XnEZS8I36nKrdFM710CRLhpTqWaVUpKu60593emmbm_PdoldVkH-K3_69WC0BUtTwur_pPT6YbKN_AaEk4k_</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1939790391</pqid></control><display><type>article</type><title>Racial and ethnic differences among children with new‐onset autoimmune Type 1 diabetes</title><source>MEDLINE</source><source>Wiley Online Library Journals Frontfile Complete</source><creator>Gandhi, K. ; Tosur, M. ; Schaub, R. ; Haymond, M. W. ; Redondo, M. J.</creator><creatorcontrib>Gandhi, K. ; Tosur, M. ; Schaub, R. ; Haymond, M. W. ; Redondo, M. J.</creatorcontrib><description>Aim
To compare demographic and clinical characteristics among children from ethnic minorities and non‐Hispanic white children with new‐onset autoimmune Type 1 diabetes.
Methods
We analysed a single‐centre series of 712 children with new‐onset autoimmune Type 1 diabetes between January 2008 and March 2011. The median (range) age was 9.7 (0.3–18.1) years, the mean (sd) BMI percentile was 69.7 (25.4) and 48.3% of the cohort were girls. The cohort comprised 57.3% non‐Hispanic white, 20.5% Hispanic and 14.8% African‐American children, and 7.4% were of other, mixed or unknown race.
Results
The Hispanic subgroup, compared with non‐Hispanic white subgroup, had a higher mean (sd) C‐peptide level [0.82 (1.62) vs 0.55 (0.47) ng/ml; P=0.004), and a greater proportion of children with elevated BMI (overweight or obesity; 49.6% vs 32.5%; P<0.001) and diabetic ketoacidosis (51.8% vs 38.2%; P=0.006). The African‐American group had a higher mean (sd) glucose level [24.4 (12.8) vs 21.4 (10.7) mmol/l; P=0.017], a greater proportion of children with ketoacidosis (56.7% vs 38.2%; P=0.001), a greater proportion with elevated BMI (52.9% vs 32.5%; P<0.001), and a lower proportion of children at pre‐pubertal stage (49.0% vs 61.6%; P=0.01), and tended to have higher C‐peptide levels [0.65 (0.59) vs 0.55 [0.47] ng/ml; P=0.079) compared with the non‐Hispanic white children. The differences in C‐peptide levels compared with non‐Hispanic white children persisted for Hispanic (P=0.01) but not African‐American children (P=0.29) after adjustment for age, sex, BMI, ketoacidosis, glucose, Tanner stage and autoantibody number.
Conclusion
At the onset of paediatric autoimmune Type 1 diabetes, Hispanic, but not African‐American children had higher C‐peptide levels, after adjustment for potential confounders, compared with non‐Hispanic white children. These findings suggest that ethnicity may contribute to the heterogeneity of Type 1 diabetes pathogenesis, with possible implications for intervention.
What's new?
At diagnosis of autoimmune Type 1 diabetes, Hispanic children, but not African‐American children, had higher C‐peptide levels compared with their non‐Hispanic white counterparts, after adjustment for potential confounders.
Ethnicity should be included in the phenotypic characterisation of subtypes of Type 1 diabetes, as it specifically contributes to heterogeneity in β‐cell function at diagnosis.
The design of intervention trials may need to consider ethnic differences among individuals with Type 1 diabetes.</description><identifier>ISSN: 0742-3071</identifier><identifier>EISSN: 1464-5491</identifier><identifier>DOI: 10.1111/dme.13408</identifier><identifier>PMID: 28626948</identifier><language>eng</language><publisher>England: Wiley Subscription Services, Inc</publisher><subject>Adolescent ; African Americans ; Body weight ; Child ; Child, Preschool ; Children ; Clinical trials ; Cohort Studies ; Continental Population Groups - statistics & numerical data ; Cross-Sectional Studies ; Cultural differences ; Diabetes ; Diabetes mellitus ; Diabetes Mellitus, Type 1 - ethnology ; Diabetic ketoacidosis ; Ethnic Groups - statistics & numerical data ; Ethnicity ; Female ; Hispanic people ; Humans ; Infant ; Ketoacidosis ; Male ; Minority & ethnic groups ; Overweight ; Overweight - complications ; Overweight - ethnology ; Pediatric Obesity - complications ; Pediatric Obesity - ethnology ; Pediatrics ; Peptides ; Racial differences</subject><ispartof>Diabetic medicine, 2017-10, Vol.34 (10), p.1435-1439</ispartof><rights>2017 Diabetes UK</rights><rights>2017 Diabetes UK.</rights><rights>Diabetic Medicine © 2017 Diabetes UK</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3888-f99572f1b5ca2678063579e35d87ebbeee54c4e3e3ba4b04209b696a2c65c22d3</citedby><cites>FETCH-LOGICAL-c3888-f99572f1b5ca2678063579e35d87ebbeee54c4e3e3ba4b04209b696a2c65c22d3</cites><orcidid>0000-0001-5871-4645</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fdme.13408$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fdme.13408$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27901,27902,45550,45551</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28626948$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Gandhi, K.</creatorcontrib><creatorcontrib>Tosur, M.</creatorcontrib><creatorcontrib>Schaub, R.</creatorcontrib><creatorcontrib>Haymond, M. W.</creatorcontrib><creatorcontrib>Redondo, M. J.</creatorcontrib><title>Racial and ethnic differences among children with new‐onset autoimmune Type 1 diabetes</title><title>Diabetic medicine</title><addtitle>Diabet Med</addtitle><description>Aim
To compare demographic and clinical characteristics among children from ethnic minorities and non‐Hispanic white children with new‐onset autoimmune Type 1 diabetes.
Methods
We analysed a single‐centre series of 712 children with new‐onset autoimmune Type 1 diabetes between January 2008 and March 2011. The median (range) age was 9.7 (0.3–18.1) years, the mean (sd) BMI percentile was 69.7 (25.4) and 48.3% of the cohort were girls. The cohort comprised 57.3% non‐Hispanic white, 20.5% Hispanic and 14.8% African‐American children, and 7.4% were of other, mixed or unknown race.
Results
The Hispanic subgroup, compared with non‐Hispanic white subgroup, had a higher mean (sd) C‐peptide level [0.82 (1.62) vs 0.55 (0.47) ng/ml; P=0.004), and a greater proportion of children with elevated BMI (overweight or obesity; 49.6% vs 32.5%; P<0.001) and diabetic ketoacidosis (51.8% vs 38.2%; P=0.006). The African‐American group had a higher mean (sd) glucose level [24.4 (12.8) vs 21.4 (10.7) mmol/l; P=0.017], a greater proportion of children with ketoacidosis (56.7% vs 38.2%; P=0.001), a greater proportion with elevated BMI (52.9% vs 32.5%; P<0.001), and a lower proportion of children at pre‐pubertal stage (49.0% vs 61.6%; P=0.01), and tended to have higher C‐peptide levels [0.65 (0.59) vs 0.55 [0.47] ng/ml; P=0.079) compared with the non‐Hispanic white children. The differences in C‐peptide levels compared with non‐Hispanic white children persisted for Hispanic (P=0.01) but not African‐American children (P=0.29) after adjustment for age, sex, BMI, ketoacidosis, glucose, Tanner stage and autoantibody number.
Conclusion
At the onset of paediatric autoimmune Type 1 diabetes, Hispanic, but not African‐American children had higher C‐peptide levels, after adjustment for potential confounders, compared with non‐Hispanic white children. These findings suggest that ethnicity may contribute to the heterogeneity of Type 1 diabetes pathogenesis, with possible implications for intervention.
What's new?
At diagnosis of autoimmune Type 1 diabetes, Hispanic children, but not African‐American children, had higher C‐peptide levels compared with their non‐Hispanic white counterparts, after adjustment for potential confounders.
Ethnicity should be included in the phenotypic characterisation of subtypes of Type 1 diabetes, as it specifically contributes to heterogeneity in β‐cell function at diagnosis.
The design of intervention trials may need to consider ethnic differences among individuals with Type 1 diabetes.</description><subject>Adolescent</subject><subject>African Americans</subject><subject>Body weight</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Children</subject><subject>Clinical trials</subject><subject>Cohort Studies</subject><subject>Continental Population Groups - statistics & numerical data</subject><subject>Cross-Sectional Studies</subject><subject>Cultural differences</subject><subject>Diabetes</subject><subject>Diabetes mellitus</subject><subject>Diabetes Mellitus, Type 1 - ethnology</subject><subject>Diabetic ketoacidosis</subject><subject>Ethnic Groups - statistics & numerical data</subject><subject>Ethnicity</subject><subject>Female</subject><subject>Hispanic people</subject><subject>Humans</subject><subject>Infant</subject><subject>Ketoacidosis</subject><subject>Male</subject><subject>Minority & ethnic groups</subject><subject>Overweight</subject><subject>Overweight - complications</subject><subject>Overweight - ethnology</subject><subject>Pediatric Obesity - complications</subject><subject>Pediatric Obesity - ethnology</subject><subject>Pediatrics</subject><subject>Peptides</subject><subject>Racial differences</subject><issn>0742-3071</issn><issn>1464-5491</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp10MtKAzEUBuAgiq3VhS8gATe6mDa3uWQptV6gIkgFd0Mmc8ZGZjJ1MkPpzkfwGX0S04suBLM5EL78nPwInVIypP6M8gqGlAuS7KE-FZEIQiHpPuqTWLCAk5j20JFzb4RQJrk8RD2WRCySIumjlyeljSqxsjmGdm6NxrkpCmjAanBYVbV9xXpuytzf4KVp59jC8uvjs7YOWqy6tjZV1VnAs9UCMPWvVQYtuGN0UKjSwcluDtDzzWQ2vgumj7f346tpoHmSJEEhZRizgmahViyKExLxMJbAwzyJIcsAIBRaAAeeKZERwYjMIhkppqNQM5bzAbrY5i6a-r0D16aVcRrKUlmoO5dSSSlbf5x6ev6HvtVdY_12XnEZS8I36nKrdFM710CRLhpTqWaVUpKu60593emmbm_PdoldVkH-K3_69WC0BUtTwur_pPT6YbKN_AaEk4k_</recordid><startdate>201710</startdate><enddate>201710</enddate><creator>Gandhi, K.</creator><creator>Tosur, M.</creator><creator>Schaub, R.</creator><creator>Haymond, M. W.</creator><creator>Redondo, M. J.</creator><general>Wiley Subscription Services, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>8FD</scope><scope>FR3</scope><scope>H94</scope><scope>K9.</scope><scope>P64</scope><scope>RC3</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-5871-4645</orcidid></search><sort><creationdate>201710</creationdate><title>Racial and ethnic differences among children with new‐onset autoimmune Type 1 diabetes</title><author>Gandhi, K. ; Tosur, M. ; Schaub, R. ; Haymond, M. W. ; Redondo, M. J.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3888-f99572f1b5ca2678063579e35d87ebbeee54c4e3e3ba4b04209b696a2c65c22d3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Adolescent</topic><topic>African Americans</topic><topic>Body weight</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>Children</topic><topic>Clinical trials</topic><topic>Cohort Studies</topic><topic>Continental Population Groups - statistics & numerical data</topic><topic>Cross-Sectional Studies</topic><topic>Cultural differences</topic><topic>Diabetes</topic><topic>Diabetes mellitus</topic><topic>Diabetes Mellitus, Type 1 - ethnology</topic><topic>Diabetic ketoacidosis</topic><topic>Ethnic Groups - statistics & numerical data</topic><topic>Ethnicity</topic><topic>Female</topic><topic>Hispanic people</topic><topic>Humans</topic><topic>Infant</topic><topic>Ketoacidosis</topic><topic>Male</topic><topic>Minority & ethnic groups</topic><topic>Overweight</topic><topic>Overweight - complications</topic><topic>Overweight - ethnology</topic><topic>Pediatric Obesity - complications</topic><topic>Pediatric Obesity - ethnology</topic><topic>Pediatrics</topic><topic>Peptides</topic><topic>Racial differences</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Gandhi, K.</creatorcontrib><creatorcontrib>Tosur, M.</creatorcontrib><creatorcontrib>Schaub, R.</creatorcontrib><creatorcontrib>Haymond, M. W.</creatorcontrib><creatorcontrib>Redondo, M. J.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>Technology Research Database</collection><collection>Engineering Research Database</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>Genetics Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>Diabetic medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Gandhi, K.</au><au>Tosur, M.</au><au>Schaub, R.</au><au>Haymond, M. W.</au><au>Redondo, M. J.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Racial and ethnic differences among children with new‐onset autoimmune Type 1 diabetes</atitle><jtitle>Diabetic medicine</jtitle><addtitle>Diabet Med</addtitle><date>2017-10</date><risdate>2017</risdate><volume>34</volume><issue>10</issue><spage>1435</spage><epage>1439</epage><pages>1435-1439</pages><issn>0742-3071</issn><eissn>1464-5491</eissn><abstract>Aim
To compare demographic and clinical characteristics among children from ethnic minorities and non‐Hispanic white children with new‐onset autoimmune Type 1 diabetes.
Methods
We analysed a single‐centre series of 712 children with new‐onset autoimmune Type 1 diabetes between January 2008 and March 2011. The median (range) age was 9.7 (0.3–18.1) years, the mean (sd) BMI percentile was 69.7 (25.4) and 48.3% of the cohort were girls. The cohort comprised 57.3% non‐Hispanic white, 20.5% Hispanic and 14.8% African‐American children, and 7.4% were of other, mixed or unknown race.
Results
The Hispanic subgroup, compared with non‐Hispanic white subgroup, had a higher mean (sd) C‐peptide level [0.82 (1.62) vs 0.55 (0.47) ng/ml; P=0.004), and a greater proportion of children with elevated BMI (overweight or obesity; 49.6% vs 32.5%; P<0.001) and diabetic ketoacidosis (51.8% vs 38.2%; P=0.006). The African‐American group had a higher mean (sd) glucose level [24.4 (12.8) vs 21.4 (10.7) mmol/l; P=0.017], a greater proportion of children with ketoacidosis (56.7% vs 38.2%; P=0.001), a greater proportion with elevated BMI (52.9% vs 32.5%; P<0.001), and a lower proportion of children at pre‐pubertal stage (49.0% vs 61.6%; P=0.01), and tended to have higher C‐peptide levels [0.65 (0.59) vs 0.55 [0.47] ng/ml; P=0.079) compared with the non‐Hispanic white children. The differences in C‐peptide levels compared with non‐Hispanic white children persisted for Hispanic (P=0.01) but not African‐American children (P=0.29) after adjustment for age, sex, BMI, ketoacidosis, glucose, Tanner stage and autoantibody number.
Conclusion
At the onset of paediatric autoimmune Type 1 diabetes, Hispanic, but not African‐American children had higher C‐peptide levels, after adjustment for potential confounders, compared with non‐Hispanic white children. These findings suggest that ethnicity may contribute to the heterogeneity of Type 1 diabetes pathogenesis, with possible implications for intervention.
What's new?
At diagnosis of autoimmune Type 1 diabetes, Hispanic children, but not African‐American children, had higher C‐peptide levels compared with their non‐Hispanic white counterparts, after adjustment for potential confounders.
Ethnicity should be included in the phenotypic characterisation of subtypes of Type 1 diabetes, as it specifically contributes to heterogeneity in β‐cell function at diagnosis.
The design of intervention trials may need to consider ethnic differences among individuals with Type 1 diabetes.</abstract><cop>England</cop><pub>Wiley Subscription Services, Inc</pub><pmid>28626948</pmid><doi>10.1111/dme.13408</doi><tpages>5</tpages><orcidid>https://orcid.org/0000-0001-5871-4645</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Adolescent African Americans Body weight Child Child, Preschool Children Clinical trials Cohort Studies Continental Population Groups - statistics & numerical data Cross-Sectional Studies Cultural differences Diabetes Diabetes mellitus Diabetes Mellitus, Type 1 - ethnology Diabetic ketoacidosis Ethnic Groups - statistics & numerical data Ethnicity Female Hispanic people Humans Infant Ketoacidosis Male Minority & ethnic groups Overweight Overweight - complications Overweight - ethnology Pediatric Obesity - complications Pediatric Obesity - ethnology Pediatrics Peptides Racial differences |
| title | Racial and ethnic differences among children with new‐onset autoimmune Type 1 diabetes |
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