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

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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 foreign-born 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.

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Acknowledgments

The SEARCH for Diabetes in Youth Study is indebted to the many youth and their families, and their health care providers, whose participation made this study possible. Grant Support: 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). The contents of this paper are solely the responsibility of the authors and do not necessarily represent the official views of the Centers for Disease Control and Prevention and the National Institute of Diabetes and Digestive and Kidney Diseases.

Conflict of interest

LM Jaacks, R Oza-Frank, R D’Agostino, Jr., LM Dolan, D Dabelea, JM Lawrence, C Pihoker, MR O’Connor, B Linder, G Imperatore, M Seid, KMV Narayan, and EJ Mayer-Davis have no conflicts of interest to disclose.

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Authors and Affiliations

  1. Department of Nutrition, The University of North Carolina, 2211 McGavran-Greenberg Hall, 135 Dauer Drive, Campus Box 7461, Chapel Hill, NC, 27599, USA

    Lindsay M. Jaacks & Elizabeth J. Mayer-Davis

  2. Department of Pediatrics, Research Institute at Nationwide Children’s Hospital, The Ohio State University, Columbus, OH, USA

    Reena Oza-Frank

  3. Department of Biostatistics, Wake Forest University School of Medicine, Winston-Salem, NC, USA

    Ralph D’Agostino Jr.

  4. Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA

    Lawrence M. Dolan & Michael Seid

  5. Department of Epidemiology, The University of Colorado, Denver, CO, USA

    Dana Dabelea

  6. Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, CA, USA

    Jean M. Lawrence

  7. Seattle Children’s Hospital, Seattle, WA, USA

    Catherine Pihoker & M. Rebecca O’Connor

  8. National Institutes of Health, NIDDK, Bethesda, MD, USA

    Barbara Linder

  9. Center for Disease Control and Prevention, Atlanta, GA, USA

    Giuseppina Imperatore

  10. Hubert Department of Global Health, Emory University, Atlanta, GA, USA

    K. M. Venkat Narayan

  11. Department of Medicine, The University of North Carolina, Chapel Hill, NC, USA

    Elizabeth J. Mayer-Davis

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  1. Lindsay M. Jaacks
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  2. Reena Oza-Frank
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  3. Ralph D’Agostino Jr.
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  4. Lawrence M. Dolan
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  5. Dana Dabelea
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  6. Jean M. Lawrence
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  9. Barbara Linder
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  10. Giuseppina Imperatore
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  11. Michael Seid
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Correspondence to Elizabeth J. Mayer-Davis.

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Jaacks, L.M., Oza-Frank, R., D’Agostino, R. et al. Migration Status in Relation to Clinical Characteristics and Barriers to Care Among Youth with Diabetes in the US. J Immigrant Minority Health 14, 949–958 (2012). https://doi.org/10.1007/s10903-012-9617-3

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  • DOI: https://doi.org/10.1007/s10903-012-9617-3

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