6281 First year of care in type 1 diabetes- are socioeconomic factors a key influence?

Objectives In recent years there has been increasing concern about ethnicity and deprivation related variation in glycemic outcomes as defined by glycosyated haemoglobin (HbA1C) values, with particular focus on the impact of inequitable use of diabetes technology.1 As a service with low use of diabetes technology for various reasons, we were uniquely placed to examine the influence of deprivation on glycaemic outcomes in the absence of inequitable technology use. Methods We examined first year of care data for all patients with a new diagnosis of type 1 diabetes in 2021. We collected information on age, ethnicity and socio economic deprivation as obtained from the English indices of deprivation 2019 postcode look-up tool. We also looked at presentation in diabetic ketoacidosis at diagnosis, use of diabetes technology, clinic attendance, number of contacts outside clinic, diabetes related hospitalisation and HbA1C during the first year of care. Results In this cohort of 25 patients, 24% were of Black and Asian ethnicity; 44% were from the two most deprived quintiles. The median age at diagnosis was 8 (range 1–16) years. 12 patients (48%) presented in diabetic ketoacidosis; 33% from the most deprived areas. Median length of stay in hospital following diagnosis was 5 days. Median number of contacts outside clinic was 31(range 13–69). Of those who received more than 31 contacts outside clinic, only 27% were from the most deprived areas. Median number of clinic appointments offered was 4.5/year. Fewer patients from the most deprived quintiles missed 1 or more clinic appointments (33% vs 66%). At 12 months post diagnosis most patients (24/25) were using flash or continuous glucose monitoring, but only 12% were on pump therapy. None of the patients in our cohort had a HbA1C Conclusion Despite small patient numbers and the very limited definition of deprivation used, our data demonstrates that in the first year following a diagnosis of type 1 diabetes there is no link between socioeconomic deprivation and demand for additional healthcare professional support, as defined by hospital stay at diagnosis and thereafter, or contacts with the team outside clinic. Although we hypothesised that socioeconomic deprivation would be a barrier to attending hospital based clinic appointments, we did not find evidence of this. In our cohort of patients with low diabetes technology use, we did not find any difference in glycemic outcomes by deprivation but a clear need to improve first year of care outcomes for all our patients. References Catherine JP, Russell MV, Peter CH. The impact of race and socioeconomic factors on paediatric diabetes. EClinicalMedicine 2021 Nov 6;42:101186. doi: 10.1016/j.eclinm.2021.101186. PMID: 34805811; PMCID: PMC8585622.