Endocrine Abstracts

Introduction: Language barriers can pose a significant barrier to successful education of children and young people (CYP) with type 1 diabetes (T1DM) and their families, potentially influencing their glycaemic control.

Methods: Retrospective analysis from diagnosis to 18 months post diagnosis of glycaemic control in 41 CYP with T1DM requiring interpreter support (INT) under care of our diabetes centre based within a multi-ethnic community. Median HbA1c at 0, 3, 6, 9, 12 and 18 months following diagnosis were compared to 100 age-, sex- and mode-of-therapy-matched controls who did not require interpreter service. English indices of deprivation are based on the 2015 census and were retrieved from: www.gov.uk/government/statistics.

Results: The main languages spoken were Somali (27%), Urdu (19.5%), Romanian (17%) and Arabic (12%), but also Polish, Hindi, Tigrinya, Portuguese, Bengali and sign language. Overall deprivation was worse in the INT group according to Index of Multiple Deprivation (IMD [median]: INT 1.642; control 3.741; P=0.001). The median HbA1c was higher at diagnosis in the control group (9.95 versus 9.0%, P=0.046) but was higher in the INT group after diagnosis: the median HbA1c at 18 months post diagnosis was 8.3% (INT) versus 7.9% (controls) (P=0.014). There were no hospital admissions required due to diabetes-related complications in both subgroups.

Summary and conclusions: Glycaemic control is worse in CYP with T1DM who face language barriers in our centre. Socioeconomic deprivation may confound these findings but indicate that this is a disadvantaged subset of patients regardless. In order to improve diabetes care for CYP with language barriers, we propose that health care providers develop strategies to provide tailored support, including provision of diabetes-specific training for interpreters. Equally, patients and their families should be supported to acquire language skills for ongoing diabetes education. The findings of this study suggest that equally poor health outcomes for CYP with language barriers and anychronic condition is a broader concern. This highlights the need for a sustained medical and political effort toward the effective integration and support of CYPs from disadvantaged backgrounds.