Introduction and Objective: Youth with T1D and elevated HbA1c experience higher rates of short- and long-term complications. While individuals from some racial and ethnic groups are at greater risk of disparities in HbA1c due to systemic barriers and discrimination, less is known about the impact on family functioning amongst youth already experiencing elevated HbA1c. This study examines disparities in racially and ethnically diverse youth with elevated HbA1c.Methods: Youth (N=217) from 5 academic medical centers were enrolled if they were 1) 12-17 years old, 2) diagnosed with T1D for ≥ 1 year, and 3) had an HbA1c ≥ 10%. Chart review collected HbA1c values. Youth and their caregivers completed measures of family functioning (Diabetes Family Conflict Scale-R, Diabetes Family Responsibility Questionnaire). Bivariate correlations and non-parametric t-tests were conducted.Results: Youth had a mean age of 14.6±1.6 years and mean HbA1c of 11.0±1.9%. 45.9% were non-Latinx White; 13.8% were Black; 21.6% were Latinx. Black youth experienced higher HbA1c and reported higher conflict regarding direct management of T1D levels compared to non-Black youth (p<.05). Latinx youth had higher indirect T1D responsibility (M=10.3 vs 8.7) and conflict regarding indirect management (M=13.4 vs. 11.8) compared to non-Latinx youth (p<.05). Higher youth-reported family conflict was associated with higher HbA1c (r=.29, p<.01).Conclusion: Youth with T1D from racial and ethnic groups who have been historically marginalized experience significant disparities in health and life outcomes, and this is even more evident in youth with elevated HbA1c. These findings suggest that disparities have an exponentially negative impact on Black and Latinx youth living with T1D. Interventions that are specifically designed for and implemented with minoritized youth with T1D need to be a priority in providing equitable access to specialty care, diabetes technology, and other health-promoting services and resources.
E. Washington: None. K.A. Torres: None. J. Flores Garcia: None. C. Jenisch: None. J. Raymond: None. M.A. Clements: Consultant; Glooko, Inc. Research Support; Dexcom, Inc., Abbott. D. Naranjo: Consultant; Sanofi. J.C. Wong: Research Support; Abbott, Dexcom, Inc., Tandem Diabetes Care, Inc. A. Reed: None. M.A. Harris: None. D.V. Wagner: None.
JDRF
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