Introduction and Objective: Private integrated healthcare and public safety-net care systems address the medical needs of different socioeconomic (SES) status groups. Irrespective of SES, many young adults with T1D struggle with diabetes management. The study evaluated survey data of Black young adults with T1D in two different healthcare systems to understand psychosocial factors, diabetes care behaviors and health outcomes. Methods: Participants were Black young adults with T1D (18-30 years) from a private, integrated healthcare system and a public safety-net hospital-based system with HbA1c > 7.5%. Data were from baseline assessment of an ongoing randomized trial measuring social determinants of health, Diabetes Distress (DDS), Diabetes Self-Management (DSMQ), and HbA1c. T- and Chi-Square Tests assessed differences by recruitment site.Results: Data were collected from 52 Black young adults with T1D (25 private care, 27 public care). Mean age=23.8 years and 38% were male. Mean diabetes distress and self-management scores in private care and public care were 3.4 (SD=1.0) and 2.8 (SD=1.1) (p=.03) and 5.0 (SD=1.8) and 5.6 (SD=1.9) (p=.20), respectively, indicating high and moderate distress and suboptimal self-management. Overall, participants self-reported high financial insecurity (60%). Public care participants reported higher food insecurity (55.6% vs. 28.0%, p=.04) and higher HbA1cs (11.2% vs. 9.3%., p=.0003). Conclusion: Despite better glycemic control in private care, HbA1cs were high across both healthcare systems. Attention should be given to Black young adults with T1D to alleviate diabetes distress, financial challenges, and barriers to self-management regardless of healthcare system. For patients in public care, additional screening and intervention for food insecurity should be considered.
R. Wolf: None. J. Haw: None. P. Vellanki: Advisory Panel; Eli Lilly and Company. A.F. Hudgins: None. J.I. Barzilay: Stock/Shareholder; Eli Lilly and Company, Medtronic, AbbVie Inc. Other Relationship; Bayer Pharmaceuticals, Inc. Stock/Shareholder; Gilead Sciences, Inc, Merck & Co., Inc. Research Support; National Institutes of Health. Stock/Shareholder; Vertex Pharmaceuticals Incorporated. M. Crawford: None. L. Fisher: None. L.M. Gonzalez Paz: None. I. Graetz: Research Support; Pfizer Inc, PRIME Education, LLC. C. McCracken: None. T.L. Davis: None.
National Institute of Health, National Institute of Diabetes and Digestive and Kidney Diseases (5R01DK128236); Helmsley Charitable Trust (2310-06383)
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