Endocrine Abstracts

Introduction: Effective communication between care providers and parents/carers is fundamental for the management of children with Type 1 diabetes. National guidelines highlight the importance of communicating effectively with parents of limited understanding of English. This study evaluates whether parental language proficiency is related to glycaemic control in a paediatric diabetes clinic serving an inner city multi-ethnic population.

Method: Routine data was collected between 1/4/17–31/3/18 at a single London centre from patients diagnosed with Type 1 Diabetes for >1 year. Data included demographics (age, gender, duration of diabetes, deprivation scores), insulin regimen, psychological wellbeing scores and HbA1c. English language proficiency of the main parent/carer for diabetes care was ranked by the diabetes team as basic (group 1: requires interpreter), independent (group 2: manages without interpreter but not fluent) or proficient (group 3: native or fluent in English as second language). HbA1c was compared and adjusted for confounders. Statistical analysis: ANOVA, ANCOVA, t-test and c-Square, using SPSSv24 at 5% significance.

Results: Ninety-five (m:f=45:50) patients were included and categorised into group 1(n=18), 2(n=9), and 3(n=68). Their age ranged between 3.4 and 19.7 years (Median=14.7), diabetes duration ranged between 1 and 16.3 years (Median=5.4) and HbA1c ranged between 43 and 130 mmol/mol (Median=69.4). Within group 1, Somalian (39%) was the most commonly spoken of the nine different non-English languages. HbA1c scores (geometric means) were significantly higher in group 1 (84.6 mmol/mol) compared with groups 2 (70.5 mmol/mol, P=0.04) and 3 (68 mmol/mol, P=0.01). No significant difference was found between groups 2 and 3. Despite significant differences in deprivation scores between groups, (P=0.001), when controlled for, HbA1c remained significantly different between groups (group 1 vs 2: P=0.01, 1 vs 3: P=0.011). No group differences in gender, age, duration of diagnosis, psychological wellbeing scores. There were more pump users in group 3(32%) vs 1(6%), but no differences in HbA1c scores were identified.

Conclusion: Language proficiency is identified as a potential barrier to optimal glycaemic control. Targeted measures such as language-specific education material/activities, support groups and key workers should be considered.