Endocrine Abstracts

Introduction: In recent years there has been a highlight on the inequity of diabetes care and results across the UK. Research needs to be taken into barriers of access to technology for type 1 diabetes in CYP in the UK, specifically looking at provider bias, systemic issues within the health system, and individual and family factors.

Aim of the study: We explored the potential factors that might affect access to technology for children with Type1 diabetes mellitus, including age; ethnicity; language barrier; deprivation and psychological support.

Methodology: A cohort of ten children diagnosed with Type 1 diabetes, cared for by Evelina Children’s Hospital between April 2022 to April 2023, declined the offer of insulin pump therapy. We telephoned the families at least six months later to discuss the reasons behind the decision.

Results: Within the group, 60% were male, and 40% were female. 80% were 11–16 years of age. The ethnicities included 40% Black-African, 20% White British children, 10% White background, 10% mixed-White, 10% Black Caribbean and 10% others. Mean HbA1C according to ethnic group was in Black African (N=4)9.87%, White British (N=2) 8.3%, White-any other White background(N=1) 8.60%, mixed White Back African(N=1)9.40%, Mixed-White and Black Caribbean(N=1) 8.60%, any other ethnic group (N=1)8.40%. Psychological support and access to technology: All patients had access to a psychologist. 60% of patients who declined pump technology had received psychological support. 83.3% of the 60% had attended at least 50% of their psychology appointments. Deprivation and access to technology: It was evident that declining Insulin pump was common in Black-African living in the third most deprived quintile, Followed by White British children living in the second most deprived quintile.

Conclusion: Teenage patients were most likely to decline the offer of insulin pump therapy. This was most apparent in children of black ethnicity, followed by White British children. Those from Black ethnic backgrounds had the highest HbA1c; over half of the patients in this group engaged with psychology. A significant proportion of children declining Insulin pumps live in the third deprivation quintile.