PSUN316 Racial Disparities in Diabetes Control and Use of Technology in a High Risk Cohort of Youth with Diabetes

Abstract

Background Racial and ethnic minority children experience significant disparities in achieving the American Diabetes Association-recommended hemoglobin A1c (HbA1c) levels when compared to non-Hispanic Whites (NHW). Continuous glucose monitoring (CGM) and insulin pump (IP) use are associated with improved glycemic control. Racial and ethnic disparities exist in the use of these technologies in youth with Type 1 diabetes (T1D), which may contribute to the observed poor glycemic outcomes in this population. However, racial and ethnic differences in CGM and IP use have not been examined in children and adolescents with diabetes. Objective We describe the differences in glycemic control, CGM and IP use in an ethnically diverse cohort of children and adolescents seen in a multidisciplinary diabetes clinic designed to provide support (i.e., diabetes education, psychology, social work, nutrition) to youth with poorly controlled diabetes. Methods Demographic data, HbA1c levels, CGM and IP use were collected from a cohort of high-risk youth with T1D and T2D attending a multidisciplinary diabetes clinic from January to December of 2021. Results A total of 125 children and adolescents (age: 4-20 years) diagnosed with diabetes were included. Twenty (16%) were African Americans (AA), 81 (65%) Hispanic (H), 23 (15%) non-Hispanic White (NHW), and 1 (0.8%) Asian (A). The mean HbA1c in the cohort was 9.07%. HbA1c in AA patients was 12.9% (SD + 3.11), in Hispanics 8.64% (SD + 2.28), and 9.00% (SD + 1.84) in NHW. Seventy percent of AA patients had an A1c> 9%, compared to 36% of Hispanics and 48% of NHW. Use of CGM and IP was 40% and 10% in AA, 79% and 36% in Hispanics, and 82% and 57% in NHW, respectively. Conclusions Our study describes recent data on glycemic control and use of diabetes technology among a racially diverse cohort of children and adolescents seen in a multidisciplinary diabetes clinic. Consistent with literature on adults, HbA1c was highest and CGM and IP use were lowest in AA as compared to H and NHW youth. Data was collected during the COVID-19 pandemic, which may have disproportionately impacted AA patients’ economic, social, and personal behaviors that may contribute to diabetes care. These data support the need for multidisciplinary interventions using systems-based and culturally tailored approaches to improve access and use of technology for diabetes management. The current multidisciplinary diabetes clinic is designed to identify high-risk factors and reduce barriers to optimal management of diabetes. Future research will focus on the impact of multidisciplinary intervention on diabetes control through the use of technology, especially for African Americans. Presentation: Sunday, June 12, 2022 12:30 p.m. - 2:30 p.m.