Glycemic control and type 1 diabetes: the differential impact of model of care and income

Objective: To examine the effect of model of care (specialist care vs. shared care), and income, on glycemic control in a sample of young people with type 1 diabetes. Methods: A total of 158 children and young people with type 1 diabetes, aged 8-19 yr, and their families, were recruited independent of their source of care as part of a longitudinal, cross-sectional exploratory study. At enrollment, participants completed a series of questionnaires and underwent a structured interview to gather data regarding the type of specialist and healthcare services attended, as well as demographic, healthcare, and self-care information. Capillary sample was taken for HbA1c determination. Results: The mean HbA1c for the group as a whole was 8.6 +/- 1.4%. There was no effect for model of care on glycemic control. However, young people living in households with a family income of less than AUS$83 000 (US$73 500) per year had a significantly higher mean HbA1c than their counterparts reporting a higher household income (8.8 +/- 1.4% vs. 8.3 +/- 1.1%; p = 0.019). Conclusion: Although no differences were found with respect to the short-term impact of specialist vs. shared care, it is evident that more support is required to improve glycemic control in this sample of young people where the mean level of HbA1c was significantly higher than target. Further research is also indicated to determine the relationship between glycemic control and socioeconomic status.