BSPED2023 Poster Presentations Diabetes 4 (12 abstracts)
The impact of COVID-19 and ethnicity on the outcomes of type 1 diabetes in children
Fareen Akhtar 1 , Rachel Drage 1 , Tim Barrett 1 , Ruth Krone 2 , Renuka Dias 2 , Vrinda Saraff 2 , Zainab Mohammed 2 , Suma Uday 2,1 , Jan Idkowiak 2,1 , Lesley Drummond 2 , Louise Collins 2 , Catarina Leal 2 & Melanie Kershaw 2
1University of Birmingham, Birmingham, UK; 2Birmingham Women’s and Children’s Hospital, Birmingham, UK
Background: The National Paediatric Diabetes Audit consistently highlights disparity in Type 1 diabetes outcomes across different ethnic groups. During COVID concerns escalated as the impact of lockdowns on ethnic minority groups had potential to inflate pre-existing health divides. This study aims to consider if COVID-19 differentially impacted children with Type 1 diabetes in different ethnic groups (White, Black, Asian, Mixed, Other).
Method: A retrospective longitudinal study of outcome in a tracked cohort of 142 children and young people diagnosed with Type 1 diabetes for a minimum of 12 months, and who remained in the centre’s care throughout the pre, peri and post COVID periods (45 months) together with records of specific diabetes care interventions. Statistical analyses comprised Anova (SPSS), T-test and Z test.
Results: 142 patients (mean age 11.1 years) were included, 12% required interpreters. 61%(N=87) were non-white. Mean HbA1c did not differ between ethnic groups pre, peri and post COVID or longitudinally. More frequent HbA1c measurements were taken from children of Asian and Black ethnicity pre COVID (P=0.003) but not peri and post COVID. Children from Black and Asian ethnic minorities had a mean 3–3.9 mmol/moL higher HbA1c throughout compared with white children (non-significant). Black minorities had the greatest drop in the total number of diabetes care contacts, having had the highest numbers pre COVID compared to white (P=0.011) and Asian children (P=0.036). Children needing interpreters had significantly more clinic appointments offered (pre and peri COVID P<0.0001, mean 54 vs 43, and 57 vs 40 contacts respectively) and more HbA1c readings taken peri-COVID (P=0.01), thus were seen more often face-to-face. No differences were seen in the BMI Z score, dietetic or educational contacts. There was no significant difference in diabetes therapy between ethnic groups, but interpreter requirement significantly reduced the likelihood of insulin pump therapy pre (P=0.014) and post (P=0.024) COVID.
Conclusion: There was no change in HbA1c between ethnic groups pre, post or peri-COVID. Differences were seen in care delivery in Asian and Black ethnic minorities, and those requiring interpreters, but this did not appear to adversely affect outcomes and may have been protective.
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