This article is more than 5 years old. Information may no longer be current.
Diabetes control poorer in children of parents with lower military rank
Children with type 1 diabetes and at least one parent who is an enlisted service member are more likely to have higher HbA1c levels and diabetes-related hospitalizations and less likely to use insulin pumps than the children of military officers, according to research in Pediatric Diabetes.
The results of the cross-sectional, retrospective chart review of children with type 1 diabetes in military families suggest that socioeconomic status — and not access to health care — can affect diabetes management, the researchers said.
“As all active duty service members and their families are provided complete health care coverage and equal access to care, the better glycemic control in the officer group is likely related to higher income, socioeconomic status and education level,” the researchers wrote. “Race also had an independent effect on HbA1c and should be investigated in further studies.”
Rachael Paz, MD, of the department of pediatrics at Walter Reed National Military Medical Center in Bethesda, Maryland, and colleagues analyzed data from 281 children aged 2 to 19 years (mean age, 15 years) between 2006 and November 2012 with type 1 diabetes for at least 1 year and a parent who is a military service member. Within the cohort, 136 children (48.4%; 38.2% black) had an enlisted parent; 145 children (51.6%; 9% black) had a parent with an officer rank.
Researchers found that the average HbA1c was 9.2% for children of enlisted service members vs. 8.4% for children of officers (P < .001). The difference remained after adjusting for race and age. In the enlisted group, 39% of children had diabetes-related hospitalizations vs. 19.3% for children of officers (P < .001). Insulin pump use also was higher among children of officers — 54.5% vs. 28.7% of children in the enlisted group (P < .001).
“The differences in HbA1c and hospitalization rate between the two groups could be explained by disparate income and education level between the officer and enlisted group, with officers having a higher income and usually a higher education level,” the researchers wrote.
Researchers noted that the two groups did not differ in the number of HbA1c values obtained during the previous year of available data, a surrogate measure of the number of clinic visits.
“The two groups, therefore, do not seem to have accessed the medical system at different rates,” the researchers wrote. “Perhaps factors such as overall life stressors, less available time to focus on daily diabetes care tasks, social support and deployments play a role in those of lower rank.” – by Regina Schaffer
Disclosure: The researchers report no relevant financial disclosures.