Endocrine Abstracts

Background: The UK National Paediatric Diabetes Audit (NPDA) data reports disparities in Haemoglobin A1c (HbA1c) levels among children and young people (CYP) with Type 1 Diabetes (T1D), with higher levels in those of Black ethnic background and lower socioeconomic status who have less access to technology. We investigate HbA1c differences in a T1D cohort with higher than national average technology uptake where > 60% come from an ethnic minority and/or socioeconomically deprived population.

Design & Methods: Retrospective cross-sectional study investigating the influence of demographic factors, technology use, and socioeconomic status (SES) on glycaemic outcomes.

Results: Among 222 CYP, 60% were of ethnic minority (Asian, Black, Mixed and Other were 32%, 12%, 6% and 10% respectively) and 40% of white heritage. 94% used Continuous Glucose Monitoring (CGM) and 60% used Continuous Subcutaneous Insulin Infusion (CSII) via open or closed loop. 6% used Self-Monitoring of Blood Glucose (SMBG) and Multiple Daily Injections (MDI), 34% used CGM and MDI, 38% used CGM and CSII and 22% used Hybrid Closed-Loop (HCL) systems. Significant differences in HbA1c across therapy groups (P < 0.001) was noted with lowest HbA1c in HCL group (55 mmol/mol; P < 0.001). Despite adjusting for therapy type, the Black group had higher HbA1c than their white and Asian counterparts (P < 0.001). CYP from the most deprived tertile had significantly higher HbA1c levels (P < 0.001) but the difference was not sustained after adjusting for therapy type.

Conclusion: Advanced diabetes technologies improve glycaemic control. Whilst equalising technology access mitigates socioeconomic disparities in HbA1c, CYP from Black ethnic background continue to display a higher HbA1c.