JPP Student Journal Club Commentary: Predictors of HbA1c Trajectories in Predominantly Black Adolescents With Type 1 Diabetes

Type 1 diabetes (T1D) is a common pediatric chronic disease that requires complex, lifelong management. Prevalence of T1D increases by 3% annually (Borchers et al., 2010) with the most marked increase (220% increase in incidence between 1985 and 2009) in Black children under age 5 (Lipman et al., 2013). Black youth with T1D have worse glycemic control (Lawrence et al., 2009), greater odds of diabetic ketoacidosis and hypoglycemic events (Willi et al., 2015), a higher mortality rate (Bosnyak et al., 2005), and increased prevalence of nephropathy and retinopathy compared with non-Hispanic White youth (Lado & Lipman, 2016). Keenan et al. (this issue) found, consistent with well-documented disparities in T1D, that Black adolescents had higher average hemoglobin A1c (HbA1c) and were more likely to have undetectably highHbA1c levels (>14%) than White youths in their sample. These dramatic disparities in the health outcomes of youth with T1D are longstanding but have yet to be adequately addressed in practice.