Endocrine Abstracts

The National Paediatric Diabetes Audit 2021 uncovered widening disparity in the utilisation of diabetes technologies among children and young people (CYP) with type 1 diabetes from ethnic minorities and low socioeconomic groups. Our data revealed that only 27.5% of CYP from ethnic minorities were using insulin pump therapy, compared to 50% from a white background. Unfortunately, our current staffing levels and available resources were inadequate to address this issue effectively. However, we were fortunate to receive funding from the NHSE Diabetes Transformation Programme to enhance access to diabetes technologies for CYP from ethnic minorities and low socioeconomic groups. To achieve our objective, we established additional Bridge the Gap clinics during evenings and weekends and offered structured education and support to children and families both before and after adopting diabetes technologies. The funding allowed us to extend the working hours of diabetes specialist nurses and dieticians. Furthermore, we deployed a support worker proficient in the languages spoken by the families to facilitate communication and provide essential assistance during clinic sessions. Between October 2022 and March 2023, we successfully initiated 14 CYP on insulin pumps, including 11 from ethnic minorities and 3 from low socioeconomic backgrounds. Among the families, only 2 spoke English as their first language, while the others communicated in South Asian, Somalian, African, and Albanian languages. The average age at pump initiation was 10.7 years (range 4.2 to 16.1). Out of the 14 children, 13 are using Libre 2, and 1 child is using Dexcom G6. Prior to starting pump therapy, the average HbA1c level for this group was 74.1 mmol/mol (range 54 to 112). Three months after initiating pump therapy, their average HbA1c level reduced to 67 mmol/mol (range 50 to 90). During our interventions, we identified key barriers to accessing diabetes technologies. These included attempts to conceal the diagnosis due to associated stigma, limited numeracy and IT skills among caregivers, and a lack of culturally appropriate resources for learning and managing food items. Overcoming these obstacles will be crucial in ensuring improved access to diabetes-related technologies for CYP from ethnic minorities and lower socioeconomic groups.