Introduction and Objective: Persistent disparities in glycemic levels among youth with type 1 diabetes (T1D) suggest social and environmental factors may influence glycemic control. We aimed to evaluate associations between social drivers of health and glycemic outcomes in youth with T1D receiving care at a community diabetes clinic serving a geographically diverse population. Methods: We conducted a retrospective chart review of patients aged 1-21 years with T1D followed at the Pediatric Diabetes Clinic in a mid-sized Midwestern city with a geographically diverse catchment area between July 1, 2021, and June 30, 2024. Demographic and clinical data were obtained from the electronic medical records. Social drivers of health included race, ethnicity, insurance type, primary language, zip code-linked Area Deprivation Index, and Social Vulnerability Index (SVI) domains. The primary glycemic measure was HbA1c. Secondary outcomes encompassed number of diabetic ketoacidosis (DKA) admissions, emergency department visits, and missed appointments. Associations between SVI percentile and glycemic and health outcomes were assessed using simple linear regression. Results: A total of 258 youth met inclusion criteria. Only SVI was associated with glycemic outcomes. Higher SVI percentile was significantly associated with higher mean HbA1c and higher HbA1c at the most recent visit (p0.01 and p0.01, respectively). Several individual SVI domains including household composition, housing type, minority and socioeconomic status, were also significantly associated with higher HbA1c (all p0.05).Social drivers were not significantly associated with DKA admissions, ED visits, or missed appointments. Conclusion: Greater SVI was associated with higher glycemic levels among youth with T1D. These findings support incorporating social risk assessment into pediatric diabetes care to help identify high risk populations and reduce health disparities. Disclosure S. Abdelhadi: None. R. Wasserman: None. A. Brubaker: None. T.N. McGoff: None. B. Ergun-Longmire: None. P. Vining Maravolo: None. H. Baker: None.
ABDELHADI et al. (Fri,) studied this question.