608-P: The Association of Perceived Discrimination with Diabetes Management in Youth and Young Adults with Youth-Onset Diabetes

by sugaradmin



Introduction and Objective: Discrimination can lower self-esteem and undermine self-care and health seeking behaviors, but its impact on young people with diabetes is poorly studied. We assessed if perceived discrimination was associated with diabetes management among youth and young adults (YYA) with youth-onset type 1 (T1D) and type 2 diabetes (T2D).Methods: We conducted a cross-sectional analysis of the multicenter SEARCH Food Security Cohort (2018-2023) among 782 YYA with youth-onset T1D and 110 with T2D (age range 11-37 years). The 10-item Everyday Discrimination Scale, hemoglobin A1c (HbA1c), and self-reported diabetes management were analyzed using logistic regression models adjusted for age, sex, race/ethnicity, study site, education, income, health insurance, food insecurity, diabetes duration, insulin regimen, and continuous glucose monitor use.Results: Overall, 57.7% of YYA (T1D 59.0%, T2D 49.1%) reported experiencing discrimination. Of YYA who reported discrimination, 41.8% (T1D 40.6%, T2D 51.9%) experienced it a few times a year or more. Among YYA with T1D who reported discrimination, the most mentioned reasons were gender (36%), age (33%), weight (24%) and race/ethnicity (21%); among YYA with T2D they were race/ethnicity (59%), weight (54%), and education or income (33%). Each one-point increase in the mean discrimination summary score was associated with greater odds of elevated HbA1c ≥ 7% (OR=1.9, 95% CI = 1.3-2.8), missing diabetes medication(s) (OR=1.6, 95% CI = 1.2-2.0) and severe hypoglycemia (OR=1.5, 95% CI = 1.1-1.9) in YYA with T1D. No associations were found in YYA with T2D.Conclusion: Most YYA with diabetes reported experiencing some form of discrimination but the reasons differed by diabetes type. Among participants with T1D, experiencing more discrimination was associated with poorer diabetes management and higher HbA1c levels. The reasons for the differences between diabetes types need to be further explored.

Disclosure

E.F. Julceus: None. A.D. Brown: None. J.A. Mendoza: None. F. Malik: None. D.M. Krobath: None. A. Bellatorre: None. T.A. Bekelman: None. L. Knight: None. C. Pihoker: None. A.D. Liese: None.

Funding

National Institute of Diabetes and Digestive and Kidney Diseases (R01DK117461); National Institute of General Medical Sciences (T32-GM081740)



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