Diabetes-Specific and General Life Stress and Glycemic Outcomes in Emerging Adults With Type 1 Diabetes: Is Race/Ethnicity a Moderator?
Diabetes-Specific and General Life Stress and Glycemic Outcomes in Emerging Adults With Type 1 Diabetes: Is Race/Ethnicity a Moderator?
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DOI：
10.1093/jpepsy/jsx092
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发表时间：
2017-10-01
影响因子：
3.6
通讯作者：
Hilliard, Marisa E.
中科院分区：
文献类型：
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作者：
Butler, Ashley M.;Weller, Bridget E.;Hilliard, Marisa E.
目的本研究探讨种族/民族是否调节了(a)糖尿病应激和一般生活应激源与(b)新生成人（18-25岁）1型糖尿病（T1D）的血糖控制和糖尿病酮症酸中毒（DKA）的关系。方法采用T1D Exchange Registry的非西班牙裔白人、非洲裔美国人和西班牙裔新生成人样本（N = 3440），采用多组分析来确定种族/民族是否会调节压力与糖尿病结局之间的关系。结果两种应激类型与血糖控制之间的关系在非裔美国人和非西班牙裔白人之间没有差异。然而，与非西班牙裔白人相比，较高的糖尿病特异性压力和较差的血糖控制之间的联系在西班牙裔人中明显更强，当他们经历相对较少的一般生活压力源时，西班牙裔人的血糖控制较差。压力类型（糖尿病特异性压力和一般压力）与DKA之间的关系在种族/民族群体中没有差异。结论：未来的研究应评估西班牙裔与非西班牙裔白人之间应激与血糖控制之间不同关系的可能机制。
Objective This study examines whether race/ethnicity moderates relationships of (a) diabetes stress and general life stressors with (b) diabetes outcomes of glycemic control and diabetic ketoacidosis (DKA) among emerging adults (aged 18-25 years) with type 1 diabetes (T1D). Method Using a T1D Exchange Registry sample of non-Hispanic White, African American, and Hispanic emerging adults (N = 3,440), multiple group analyses were used to determine whether race/ethnicity moderates the relationships between stress and diabetes outcomes. Results The relationships between the two stress types and glycemic control did not differ between African American and non-Hispanic Whites. However, as compared with non-Hispanic Whites, the association between higher diabetes-specific stress and poorer glycemic control was significantly stronger for Hispanics, and Hispanics had poorer glycemic control when they experienced a relatively fewer number of general life stressors than non-Hispanic Whites. The relationships between the type of stress (diabetes-specific and general stress) and DKA did not differ across racial/ethnic groups. Conclusions Future research should evaluate possible mechanisms that contribute to the different relationships of stress with glycemic control among Hispanics compared with non-Hispanic Whites.