Health Care Access and Glycemic Control in Youth and Young Adults with Type 1 and Type 2 Diabetes in South Carolina

Details

• Alternative Title:
  Pediatr Diabetes
• Personal Author:
  Liese, Angela D. ; Ma, Xiaonan ; Reid, Lauren ; Sutherland, Melanie ; Bell, Bethany A. ; Eberth, Jan M. ; Probst, Janice C. ; Turley, Christine B. ; Mayer-Davis, Elizabeth J.
• Description:
  Affordability and geographic accessibility are key health care access characteristics. We used data from 481 youth and young adults (YYA) with diabetes (389 type 1, 92 type 2) to understand the association between health care access and glycemic control as measured by HbA| values. In multivariate models, YYA with state or federal health insurance had HbA| percentage values 0.68 higher (P = 0.0025) than the privately insured, and those without insurance 1.34 higher (P < 0.0001). Not having a routine diabetes care provider was associated with a 0.51 higher HbA| (P = 0.048) compared to having specialist care, but HbA| did not differ significantly (P = 0.069) between primary vs specialty care. Distance to utilized provider was not associated with HbA| among YYA with a provider (P = 0.11). These findings underscore the central role of health insurance and indicate a need to better understand the root causes of poorer glycemic control in YYA with state/federal insurance.
• Subjects:
  Adolescent Adult Blood Glucose Child Child Health Services Diabetes Mellitus, Type 1 Diabetes Mellitus, Type 2 Female Glycated Hemoglobin Health Services Accessibility Humans Insurance, Health Insurance Coverage Male Patient Protection And Affordable Care Act South Carolina Young Adult

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• Keywords:
  Children’s Health Determinants Of Health Diabetes Health Care Access Insurance Coverage
• Source:
  Pediatr Diabetes. 20(3):321-329
• Pubmed ID:
  30666775
• Pubmed Central ID:
  PMC6456401
• Document Type:
  Journal Article
• Funding:
  U18 DP006138/DP/NCCDPHP CDC HHSUnited States/ ; U18DP006138/ACL/ACL HHSUnited States/ ; U18DP006134/ACL/ACL HHSUnited States/ ; U18DP006131/ACL/ACL HHSUnited States/ ; P30 DK056350/DK/NIDDK NIH HHSUnited States/ ; U18DP006136/ACL/ACL HHSUnited States/ ; U18DP006139/ACL/ACL HHSUnited States/ ; UC4 DK108173/DK/NIDDK NIH HHSUnited States/ ; UL1 TR001450/TR/NCATS NIH HHSUnited States/ ; U01 DP000254/DP/NCCDPHP CDC HHSUnited States/ ; U18DP006133/ACL/ACL HHSUnited States/ ; U18 DP002708/DP/NCCDPHP CDC HHSUnited States/
• Volume:
  20
• Issue:
  3
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha-512:ae59ff8f632aa12ddd40cb97cd928752e9fd64349e6579f09019a94fa11b771fc61860a69b6246a9dfc6b56b0eed5dc30f0410f296c793f2f340186f229bca93
• Download URL:
  https://stacks.cdc.gov/view/cdc/77498/cdc_77498_DS1.pdf
• File Type:
  [PDF - 351.93 KB ]