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Health care access and glycemic control in youth and young adults with type 1 and type 2 diabetes in South Carolina
Author(s) -
Liese Angela D.,
Ma Xiaonan,
Reid Lauren,
Sutherland Melanie W.,
Bell Bethany A.,
Eberth Jan M.,
Probst Janice C.,
Turley Christine B.,
MayerDavis Elizabeth J.
Publication year - 2019
Publication title -
pediatric diabetes
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.678
H-Index - 75
eISSN - 1399-5448
pISSN - 1399-543X
DOI - 10.1111/pedi.12822
Subject(s) - glycemic , medicine , specialty , family medicine , health care , type 2 diabetes , type 1 diabetes , diabetes mellitus , health insurance , multivariate analysis , gerontology , environmental health , endocrinology , economics , economic growth
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 1c values. In multivariate models, YYA with state or federal health insurance had HbA 1c 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 1c ( P = 0.048) compared to having specialist care, but HbA 1c did not differ significantly ( P = 0.069) between primary vs specialty care. Distance to utilized provider was not associated with HbA 1c 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.