To estimate difference in population-level glycemic control and the emergence of diabetes complications given a theoretical scenario in which non-White youth and young adults (YYA) with type 1 diabetes (T1D) receive and follow an equivalent distribution of diabetes treatment regimens as non-Hispanic White YYA.

Longitudinal data from YYA diagnosed 2002–2005 in the SEARCH for Diabetes in Youth Study were analyzed. Based on self-reported race/ethnicity, YYA were classified as non-White race or Hispanic ethnicity (non-White subgroup) versus non-Hispanic White race (White subgroup). In the White versus non-White subgroups, the propensity score models estimated treatment regimens, including patterns of insulin modality, self-monitored glucose frequency, and continuous glucose monitoring use. An analysis based on policy evaluation techniques in reinforcement learning estimated the effect of each treatment regimen on mean hemoglobin A_1c (HbA_1c) and the prevalence of diabetes complications for non-White YYA.

The study included 978 YYA. The sample was 47.5% female and 77.5% non-Hispanic White, with a mean age of 12.8 ± 2.4 years at diagnosis. The estimated population mean of longitudinal average HbA_1c over visits was 9.2% and 8.2% for the non-White and White subgroup, respectively (difference of 0.9%). Within the non-White subgroup, mean HbA_1c across visits was estimated to decrease by 0.33% (95% CI –0.45, –0.21) if these YYA received the distribution of diabetes treatment regimens of the White subgroup, explaining ~35% of the estimated difference between the two subgroups. The non-White subgroup was also estimated to have a lower risk of developing diabetic retinopathy, diabetic kidney disease, and peripheral neuropathy with the White youth treatment regimen distribution (P < 0.05), although the low proportion of YYA who developed complications limited statistical power for risk estimations.

Mathematically modeling an equalized distribution of T1D self-management tools and technology accounted for part of but not all disparities in glycemic control between non-White and White YYA, underscoring the complexity of race and ethnicity-based health inequity.

假设患有 1 型糖尿病 (T1D) 的非白人青年和青壮年 (YYA) 接受并遵循与非白人青少年和青壮年 (YYA) 相同分布的糖尿病治疗方案，以估计人口水平血糖控制和糖尿病并发症出现情况的差异。 - 西班牙裔白人 YYA。

对青年糖尿病研究中 2002-2005 年诊断的 YYA 的纵向数据进行了分析。根据自我报告的种族/族裔，YYA 被分类为非白人种族或西班牙裔种族（非白人亚群）与非西班牙裔白人种族（白人亚群）。在白人与非白人亚组中，倾向评分模型估计了治疗方案，包括胰岛素模式、自我监测血糖频率和连续血糖监测的使用。基于强化学习中的政策评估技术的分析估计了每种治疗方案对非白人 YYA 平均血红蛋白 A _1c (HbA _1c ) 和糖尿病并发症发生率的影响。

该研究包括 978 YYA。样本中 47.5% 为女性，77.5% 为非西班牙裔白人，诊断时平均年龄为 12.8 ± 2.4 岁。非白人亚组和白人亚组的访问期间纵向平均 HbA _1c的估计人群平均值分别为 9.2% 和 8.2%（差异为 0.9%）。在非白人亚组中，如果这些 YYA 接受白人亚组糖尿病治疗方案的分布，则每次就诊的平均 HbA _1c估计会降低 0.33% (95% CI –0.45, –0.21)，这解释了约 35% 的糖尿病治疗方案两个亚组之间的估计差异。根据白人青年治疗方案的分布，非白人亚组据估计患糖尿病视网膜病变、糖尿病肾病和周围神经病变的风险也较低（ P < 0.05），尽管出现并发症的 YYA 比例较低，统计数据有限。风险评估的能力。

对 T1D 自我管理工具和技术的均衡分布进行数学建模，解释了非白人和白人 YYA 之间血糖控制方面的部分差异，但不是全部差异，强调了种族和基于种族的健康不平等的复杂性。