Association between glucose levels of children with type 1 diabetes and parental economic status in mobile health application

Wen-Hao Zhang; Chao-Fan Wang; Hao Wang; Jie Tang; Hong-Qiang Zhang; Jiang-Yu Zhu; Xue-Ying Zheng; Si-Hui Luo; Yu Ding

doi:10.4239/wjd.v15.i7.1477

Association between glucose levels of children with type 1 diabetes and parental economic status in mobile health application

World J Diabetes. 2024 Jul 15;15(7):1477-1488. doi: 10.4239/wjd.v15.i7.1477.

Authors

Wen-Hao Zhang¹, Chao-Fan Wang², Hao Wang³, Jie Tang³, Hong-Qiang Zhang¹, Jiang-Yu Zhu³, Xue-Ying Zheng¹, Si-Hui Luo¹, Yu Ding⁴

Affiliations

¹ Department of Endocrinology, The First Affiliated Hospital of University of Science and Technology of China, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei 230001, Anhui Province, China.
² Department of Endocrinology and Metabolism, The Third Affiliated Hospital of Sun Yat-sen University, Guangdong Provincial Key Laboratory of Diabetology, Guangzhou 510000, Guangdong Province, China.
³ Graduate School, Bengbu Medical College, Bengbu 233000, Anhui Province, China.
⁴ Department of Endocrinology, The First Affiliated Hospital of University of Science and Technology of China, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei 230001, Anhui Province, China. yuding6815@163.com.

Abstract

Background: The glycemic control of children with type 1 diabetes (T1D) may be influenced by the economic status of their parents.

Aim: To investigate the association between parental economic status and blood glucose levels of children with T1D using a mobile health application.

Methods: Data from children with T1D in China's largest T1D online community, Tang-TangQuan^®. Blood glucose levels were uploaded every three months and parental economic status was evaluated based on annual household income. Children were divided into three groups: Low-income (< 30000 Yuan), middle-income (30000-100000 Yuan), and high-income (> 100000 yuan) (1 Yuan = 0.145 United States Dollar approximately). Blood glucose levels were compared among the groups and associations were explored using Spearman's correlation analysis and multivariable logistic regression.

Results: From September 2015 to August 2022, 1406 eligible children with T1D were included (779 female, 55.4%). Median age was 8.1 years (Q1-Q3: 4.6-11.6) and duration of T1D was 0.06 years (0.02-0.44). Participants were divided into three groups: Low-income (n = 320), middle-income (n = 724), and high-income (n = 362). Baseline hemoglobin A1c (HbA1c) levels were comparable among the three groups (P = 0.072). However, at month 36, the low-income group had the highest HbA1c levels (P = 0.036). Within three years after registration, glucose levels increased significantly in the low-income group but not in the middle-income and high-income groups. Parental economic status was negatively correlated with pre-dinner glucose (r = -0.272, P = 0.012). After adjustment for confounders, parental economic status remained a significant factor related to pre-dinner glucose levels (odds ratio = 13.02, 95%CI: 1.99 to 126.05, P = 0.002).

Conclusion: The blood glucose levels of children with T1D were negatively associated with parental economic status. It is suggested that parental economic status should be taken into consideration in the management of T1D for children.

Keywords: Children and adolescents; Economic status; Glycemic control; Mobile health application; Type 1 diabetes.