BSPED2023 Poster Presentations Diabetes 3 (12 abstracts)
The impact of COVID-19 and social deprivation on the outcomes of type 1 diabetes in children
Rachel Drage 1 , Fareen Ahktar 1 , Tim Barrett 1 , Ruth Krone 2 , Renuka Dias 2 , Vrinda Saraff 2 , Zainab Mohammed 2 , Suma Uday 1,2 , Jan Idkoviak 1,2 , Lesley Drummond 2 , Louise Collins 2 , Catarina Leal 2 & Melanie Kershaw 2
1University of Birmingham, Birmingham, UK; 2Birmingham Women’s and Children’s Hospital, Birmingham, UK
Introduction: The National Paediatric Diabetes Audit consistently highlights disparity in Type 1 diabetes outcomes with a higher mean HbA1c observed in the most deprived socioeconomic groups. During COVID concerns escalated as the impact of lockdowns on socioeconomic deprivation had potential to inflate pre-existing health divides. Our study aimed to assess care provided and impact of socioeconomic background on diabetes outcomes through COVID in a large tertiary diabetes service.
Method: A retrospective longitudinal study of a tracked cohort of 142 children and young people diagnosed with Type 1 diabetes for a minimum of 12 months, and who remained in the centre’s care throughout pre, peri and post COVID periods (45 months). Median HbA1c was compared using English Indices of deprivation, together with records of diabetes care interventions. Statistical analyses comprised Anova (SPSS), T-test and Z test.
Results: 83% of the cohort were in the most deprived half of the English population. Whilst mean HbA1c did not significantly differ between the most and least deprived clinic quartiles pre covid, those in the least deprived quartile had a significantly lower HbA1c post COVID than the more deprived quartile (P=0.002) with an average difference of 9.3 mmol/mol. There was no significant difference in the total number of team, dietitian contacts or education clinics offered. There was more face-to-face contact with the most deprived half of the clinic who saw a smaller reduction in the number of HbA1c measurements during the lockdowns (P=0.007). Although the most deprived were significantly less likely to be on an insulin pump pre (P=0.045) and post COVID (P=0.044), its use was associated with significantly lower HbA1c pre (P<0.0001), peri (P=0.05) and post COVID (P<0.01).
Conclusion: Our report demonstrates that the general trend for improvement in HbA1c in time was attenuated in the most deprived quartile, despite the team being more likely to see those in the most deprived half of the clinic face to face, and the trend to more frequent team contacts across all socioeconomic groups. Future use of technology is key to closing the gap of the impact of socio-economic status on diabetes outcomes.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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