1298-P: Unique Patterns of Racial/Ethnic Disparities among Vulnerable Young Adults with Type 1 Diabetes

Diabetes ◽  
2019 ◽  
Vol 68 (Supplement 1) ◽  
pp. 1298-P ◽  
Author(s):  
SHIVANI AGARWAL ◽  
LAUREN KANAPKA ◽  
JENNIFER RAYMOND ◽  
ASHBY F. WALKER ◽  
ANDREA GERARD GONZALEZ ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Young Adults ◽  
Ethnic Disparities ◽  
Racial Ethnic

4-OR: Racial/Ethnic Disparities in Diabetes Self-Care in Young Adults (YA) with Type 1 Diabetes (T1D)

Diabetes ◽  
2021 ◽  
Vol 70 (Supplement 1) ◽  
pp. 4-OR
Author(s):  
RABAIL SADIQ ◽  
MELISSA FAZZARI ◽  
SHADI NAHVI ◽  
CHINAZO CUNNINGHAM ◽  
SHIVANI AGARWAL
Keyword(s):  
Type 1 Diabetes ◽  
Young Adults ◽  
Self Care ◽  
Ethnic Disparities ◽  
Racial Ethnic

3-OR: Racial/Ethnic Disparities in Diabetes Technology Use in Young Adults (YA) with Type 1 Diabetes (T1D): Multidisciplinary Stakeholder Perspectives and Solutions

Diabetes ◽  
2021 ◽  
Vol 70 (Supplement 1) ◽  
pp. 3-OR
Author(s):  
SHIVANI AGARWAL ◽  
GLADYS CRESPO-RAMOS ◽  
STEPHANIE LEUNG ◽  
MOLLY FINNAN ◽  
TINA PARK ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Young Adults ◽  
Technology Use ◽  
Ethnic Disparities ◽  
Stakeholder Perspectives ◽  
Diabetes Technology ◽  
Racial Ethnic

803-P: Modifiable Diabetes-Specific Factors and Glycemic Control in Economically Vulnerable and Racial/Ethnic Minority Young Adults with Type 1 Diabetes

Diabetes ◽  
2019 ◽  
Vol 68 (Supplement 1) ◽  
pp. 803-P
Author(s):  
SHIVANI AGARWAL ◽  
LAUREN KANAPKA ◽  
JENNIFER RAYMOND ◽  
ASHBY F. WALKER ◽  
ANDREA GERARD GONZALEZ ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Young Adults ◽  
Glycemic Control ◽  
Ethnic Minority ◽  
Specific Factors ◽  
Racial Ethnic

scholarly journals Racial-Ethnic Inequity in Young Adults With Type 1 Diabetes

2020 ◽  
Vol 105 (8) ◽  
pp. e2960-e2969 ◽  
Author(s):  
Shivani Agarwal ◽  
Lauren G Kanapka ◽  
Jennifer K Raymond ◽  
Ashby Walker ◽  
Andrea Gerard-Gonzalez ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Young Adults ◽  
Technology Use ◽  
Self Management ◽  
Diabetes Distress ◽  
Diabetes Technology ◽  
Racial Ethnic ◽  
Hispanic White ◽  
Hba1c Levels

Abstract Context Minority young adults (YA) currently represent the largest growing population with type 1 diabetes (T1D) and experience very poor outcomes. Modifiable drivers of disparities need to be identified, but are not well-studied. Objective To describe racial-ethnic disparities among YA with T1D and identify drivers of glycemic disparity other than socioeconomic status (SES). Design Cross-sectional multicenter collection of patient and chart-reported variables, including SES, social determinants of health, and diabetes-specific factors, with comparison between non-Hispanic White, non-Hispanic Black, and Hispanic YA and multilevel modeling to identify variables that account for glycemic disparity apart from SES. Setting Six diabetes centers across the United States. Participants A total of 300 YA with T1D (18-28 years: 33% non-Hispanic White, 32% non-Hispanic Black, and 34% Hispanic). Main Outcome Racial-ethnic disparity in HbA1c levels. Results Non-Hispanic Black and Hispanic YA had lower SES, higher HbA1c levels, and much lower diabetes technology use than non-Hispanic White YA (P < 0.001). Non-Hispanic Black YA differed from Hispanic, reporting higher diabetes distress and lower self-management (P < 0.001). After accounting for SES, differences in HbA1c levels disappeared between non-Hispanic White and Hispanic YA, whereas they remained for non-Hispanic Black YA (+ 2.26% [24 mmol/mol], P < 0.001). Diabetes technology use, diabetes distress, and disease self-management accounted for a significant portion of the remaining non-Hispanic Black–White glycemic disparity. Conclusion This study demonstrated large racial-ethnic inequity in YA with T1D, especially among non-Hispanic Black participants. Our findings reveal key opportunities for clinicians to potentially mitigate glycemic disparity in minority YA by promoting diabetes technology use, connecting with social programs, and tailoring support for disease self-management and diabetes distress to account for social contextual factors.

scholarly journals Racial and ethnic disparities in rates of continuous glucose monitor initiation and continued use in children with type 1 diabetes

2020 ◽  
Author(s):  
Charlene W. Lai ◽  
Terri H. Lipman ◽  
Steven M. Willi ◽  
Colin P. Hawkes
Keyword(s):  
Type 1 Diabetes ◽  
Ethnic Disparities ◽  
Racial And Ethnic Disparities ◽  
Continuous Glucose Monitor ◽  
Sustained Use ◽  
Continued Use ◽  
One Year ◽  
Racial Ethnic ◽  
Hispanic White

<b>Background: </b>Racial/ethnic disparities in continuous glucose monitor (CGM) use exist among children with type 1 diabetes. It is not known if differential rates of device initiation or sustained use drive this disparity.<b></b> <p><b>Objective: </b>To compare CGM initiation rates and continued use among non-Hispanic white (NHW), non-Hispanic black (NHB) and Hispanic children. </p> <p><b>Methods: </b>Retrospective review including children with type 1 diabetes attending Children’s Hospital of Philadelphia between 1/1/15 and 12/31/18. <b></b></p> <p><b>Results:</b> Of 1509 eligible children, 726 (48%) started CGM during the study period. More NHW (54%) than NHB (31%) and Hispanic (33%) children started CGM (p < 0.001). One-year after starting, fewer NHB (61%) than NHW (86%) and Hispanic (85%) children were using CGM (p<0.001). </p> <p><b>Conclusions:</b> Lower CGM use in NHB children was due to lower rates of device initiation and higher rates of discontinuation. Interventions to address these barriers are needed to reduce disparities in CGM use.</p>

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