Introduction and Objective: We examined differences in diabetes technology use and their association with diabetic ketoacidosis (DKA) and hypoglycemia, diabetes distress by race/ethnicity in young people with T1D.Methods: Patients between the age of 14 and 25 (n=601) seen in a large U.S. endocrinology clinic were contacted to complete surveys online, including demographic information, the T1D distress questionnaire. Data on technology DKA and hypoglycemia were obtained from the patients’ electronic health record. Technology use was defined as the use of both continuous glucose monitoring, pump, or a closed-loop hybrid system.Results: The prevalence of technology use was 75.7%, but varied by race with 78.1% in NHW, 64.4% in NHB and 70.0% among Hispanic patients. The prevalence of DKA in the past year was 9.5%. The prevalence of hypoglycemia in the past year was 7.0%. Both DKA and hypoglycemia in the past year also varied by race, with 12%,6.1% and 37.8% of Hispanic, NHW and NHB patients experiencing a DKA event in the past year and 5%,13.3% and 6.8% of NWH, NHB and Hispanic patients, respectively, experiencing a severe hypoglycemic event in the past year. High type 1 diabetes distress score also varied by race/ethnicity, 16.3%, 30.2% and 13.1% of NHW, NHB and Hispanic patients having a high type 1 diabetes distress score. Technology use was associated with a non-significantly lower type 1 diabetes distress score in NHB (OR=0.39, 0.09-1.79), but not NHW (OR=0.74, 0.38-1.42) or Hispanic patients (OR=1.45, 0.27-7.86). In analysis controlling for age, sex, and high type 1 diabetes distress score, technology use was protective of DKA among NHW (OR=0.41, 95% CI=0.17-0.97), but not NHB (OR=2.36, 95% CI=0.50-11.14) or Hispanic patients (OR=2.15 95% CI=0.32-21.32). Tech use was also protective against severe hypoglycemia among Hispanic (OR-0.06, 95% CI 0.01-0.60), but not NHW or NHB patients.Conclusion: Diabetes technology use appears to vary by race/ethnicity in its beneficial association with severe acute complications of type 1 diabetes.
R.B. Conway: None. R.I. Pereira: None. H. Gebre: None. K. Valdez: None. C.J. Chartier-Logan: None. A. Gerard Gonzalez: None. J.K. Snell-Bergeon: Stock/Shareholder; GlaxoSmithKline plc.
American Diabetes Association (11-22-ICTSHD-03)
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