Contribution of income to self-management and health outcomes in pediatric type 1 diabetes

Low income has been established as a risk factor for poorer outcomes in youth with type 1 diabetes; however, the effect of moderate income has not been studied. The purpose of this secondary analysis of baseline data from a multi-site study was to compare glycemic control, self-management, and psychosocial outcomes depression, stress, and quality of life (QOL) at different income levels in adolescents with type 1 diabetes. Youth (n = 320, mean age = 12. 3 + 1. 1, 55% female, 64% white, mean A1C = 8. 3 ± 1. 4) completed established self-management and psychosocial measures. A1C levels were collected from medical records. Caregivers reported annual family income, categorized as high (>80K), moderate (40-80K), or low (<40K). Youth from high-income families had significantly lower A1C (mean = 7. 9 ± 1. 2) than those from the moderate-income group (8. 6 ± 1. 7, p < 0. 001) or the low-income group (mean A1C = 8. 6 ± 1. 5, p = 0. 003). Youth from the high-income group reported significantly better diabetes problem solving and more self-management goals than those from the moderate- or low-income groups (both p < 0. 01). Youth from the high-income group also reported significantly fewer symptoms of depression, lower levels of perceived stress, and better QOL than those in the moderate or low-income groups (all p < 0. 05). Multivariate linear regression models were used to test psychological and behavioral predictors of A1C and QOL. Parents' education status (p < 0. 05) and self-management activities (p < 0. 01) were significant predictors of hemoglobin A1c, while income (p < 0. 01) and self-management activities (p < 0. 05) were significant predictors of QOL.