Researchers describes that young patients with type 1 diabetes from ethnic minorities are more like than their white peers to have markers of a poor prognosis, which in turn may explain their worse longer-term outcomes. The study was published in Diabetes Care.

The study of over 900 young patients with type 1 diabetes showed that African Americans were more likely to have hypertension and severe hypoglycemic events than non-Hispanic whites. They also had worse trajectories for HbA1c levels, insulin doses, percentile body mass index (BMI), and other key outcome indicators, and were less likely to have partial remission, known as the 'honeymoon period'.

The results show that young African American and Hispanic patients "have worse early outcomes and prognostic factors for complications than non-Hispanic whites during the first critical years after diagnosis of type 1 diabetes," the team writes.

However, there has been little study of ethnic differences in type 1 diabetes in terms of baseline characteristics, early outcomes, treatments, and presence of cardiovascular risk factors, say the researchers. However, African American youth had a significantly higher percentile BMI at diagnosis than whites, at a median of 70% vs 43% (P = .01) and were at a more advanced Tanner stage of pubertal development (P < .001 for trend).

African American youths were also more likely than whites to present with diabetic ketoacidosis, at 48% vs 32% (P = .004), although this ceased to be significant after considering health insurance coverage (P = .08). During follow-up, African Americans were more likely than whites to have hypertension (15% vs 7%; P = .009), severe hypoglycemic events (11% vs 4%; P = .004), and diabetic ketoacidosis episodes (53% vs 36%; P = .004).

Compared with whites, Hispanics had a significantly higher adjusted percentile BMI at diagnosis, at 64% vs 43% (P = .002). They also tended to be at a more advanced stage of puberty and be positive for GAD65 and insulin autoantibodies.

And during follow-up, Hispanics were significantly more likely than whites to have a diagnosis of dyslipidemia (P < .001) and tended to have more severe hypoglycemia, although this difference disappeared after considering parental education (P = .36).

Furthermore, this study highlights the need for research that focuses on the gaps in knowledge on the etiology of racial differences in factors that predict poor diabetes outcomes and informs intervention trials that target vulnerable populations.