Self-reported social class, self-management behaviors, and the effect of diabetes mellitus in urban, minority young people and their families.

Abstract

To document social factors, diabetes mellitus (DM) self-management, and the effect of the disease among children with DM residing in Chicago, Ill. Patients were ascertained for a population-based study of childhood-onset DM (ages, 0-17 years). Families and patients (N = 288) were interviewed about health services use, sociodemographics, self-management behaviors, and other characteristics, a mean of 6.1 years after diagnosis. Univariate and multivariate analyses were conducted. Most patients were non-Hispanic black (68.4%) or Hispanic (28.5%). Overall, 59.8% of the respondents received Medicaid or had no health insurance at the time of disease onset, including 61.7% of non-Hispanic black patients and 59.2% of Hispanic patients. Of the entire group, 61.5% reported that having DM had affected their family life in some way, with 14.9% reporting difficulty in obtaining child care and 18.4% reporting an effect on the parent and/or guardian's job. Having DM negatively affected the personal lives of 33.7% of the young people, with 13.9% having been excluded from sports activities, and 16.8% having had difficulty obtaining insurance. Among the 64 patients who were aged 20 years or older when interviewed, 21.0% had been denied employment because of their DM. The level of blood glucose was measured less than once daily by 8.8% of the respondents, while 12.4% had never been given a dilated ophthalmologic examination or had not been examined within the past year. Fully 30.6% of those aged 20 years or older smoked cigarettes. There were few ethnic differences in these characteristics. We conclude that DM has had a significant effect in this group of primarily African American and Hispanic young people who have a chronic illness.