1183-P: Neighborhood Level Deprivation Is a Key Predictor of Glycemic Outcomes in Youth-Onset Type 2 Diabetes

by sugaradmin



Introduction and Objective: Residing in disadvantaged neighborhoods is linked to negative health outcomes. We aimed to assess if neighborhood disadvantage, measured by the area deprivation index (ADI), predicts glycemic outcomes and development of complications in youth-onset type 2 diabetes (T2D).Methods: We extracted data from 2014-2024 from the University of California (UC) Health Data Warehouse which includes electronic health records from six UCs. T2D diagnosis was identified using a validated algorithm (Teltsch et al, 2019) based on medications, device use, ICD and SNOMED codes. Zip codes informed ADI scores which were analyzed in quintiles. Mixed effects logistic regression, adjusting for age, A1c at diagnosis, race/ethnicity, and sex, was used to assess the relationship between ADI and A1c levels from diagnosis to year 5. We also examined the association of ADI with the development of diabetes-related neuropathy, nephropathy, and retinopathy.Results: The sample included 2322 participants diagnosed before age 21 (mean age 15.6 y; 55% female; 75% non-white), with 67% in the three most disadvantaged ADI quintiles. Mean A1c declined in the first year across all quintiles but increased over years 1-5. Only the least disadvantaged quintile maintained a mean A1c <7% at year 5. The odds of achieving an A1c of <7% for the most disadvantaged quintile were 50% lower (P<0.001), while odds of an A1c >8.5% were 120% higher (P<0.001) compared to the least disadvantaged quintile. At diagnosis, 91 participants had microvascular complications, 76% of which were in the three highest quintiles (P<0.05). Over five years, 136 additional participants developed complications, though incidence did not differ significantly by quintile.Conclusion: ADI is linked to lower odds of achieving glycemic targets and higher baseline complication prevalence, highlighting neighborhood deprivation as a key predictor of glycemic outcomes in youth-onset T2D.

Disclosure

M. Yuasa: None. Z.D. Perez: None. J. Davidson: None. J.C. Wong: Research Support; Abbott, Dexcom, Inc., Tandem Diabetes Care, Inc. S. Srinivasan: Research Support; Abbott.



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