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 "One of the first explanations that comes to mind is that unequal
access to healthcare may be a factor linking family background and
blood sugar levels," said study leader Nick Nielsen from department
of economics at University of Copenhagen.
But studying people in Denmark, which has universal tax-financed
access to healthcare, helped cancel out that factor, he told Reuters
Health.
Nielsen and his team analyzed data on 4,079 children who were
diagnosed with type 1 diabetes between 2000 and 2013. In type 1
diabetes, the rarer form of the disease, the body's immune system
mistakenly kills the beta cells in the pancreas that make and
release the hormone insulin. Type 1 diabetes requires treatment with
insulin injections.
The children were divided into 4 groups, depending on their mother's
highest level of education. Altogether, 1,643 had mothers who hadn't
gone to college, 1,548 had mothers who completed vocational or
2-year college, 695 had mothers with bachelor's degree and 193 had
mothers with master's degree.
The researchers found that levels of so-called glycated hemoglobin,
or HbA1c, HbA1c, which reflects blood sugar control over the
previous three months, went down as mothers' education level went
up.
The normal range for HbA1c is 4.3% to 5.8% - but that range is
difficult to achieve in diabetics. The American Diabetes Association
recommends that children with type 1 diabetes strive to stay below
7.5%.
In the current study, HbA1c levels averaged 7.6% in children of
mothers with advanced degrees, 7.9% in children of women with
bachelor's degrees, 8.2% in children whose mothers graduated from
vocational or 2-year colleges, and 8.4% in children of mothers with
no more than a high school degree.
Children of better-educated mothers also had lower rates of a
dangerous condition known as diabetic ketoacidosis, and lower rates
of dangerously low blood sugar that can result from overdoses of
insulin.
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Differences in how often kids' blood sugar levels were checked uring
the day likely explained a large part of the disparities, the
authors say.
Children of the most highly educated mothers had the highest number
of daily blood glucose tests, while those with a high school
education or less had the lowest.
Other potential explanations, the authors write, are that mothers
with higher education may be more capable of helping manage diabetes
and could help their kids on how to control their disease.
Links between patient education or socioeconomic status and
compliance with treatment has been shown in older studies, too.
The study is limited because it was not possible to get information
on all mothers and their children in the registries.
Still, the researchers write in Diabetes Care, "For clinicians and
policymakers, our results suggest that it may be beneficial to
provide extra support to the least privileged children during the
first few years of diabetes."
It would also be helpful if healthcare professionals help form
patient groups, Nielsen says.
"In these groups, families could help support each other outside the
clinic. We think that this increased decentral support could be
valuable due to the importance of peer support and "everyday" advice
and knowledge sharing," Nielsen added.
SOURCE: http://bit.ly/2Jaa5XW Diabetes Care, online May 23, 2019.
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