BSPED2025 Oral Communications Diabetes Oral Communications 2 (7 abstracts)
Analysing the impact of socioeconomic deprivation and ethnicity on the development of vascular complications in young people with type 1 diabetes – a regional perspective
Afiya Andrews 1 , Victoria Homer 2,3 , Hung-Ye Chien 4 , Sarah Barton 4 , Amelia Briggs 4 , Rocco Sheldon 1 , Chamila Balagamage 1 , Lauren Quinn 4,5 , Parth Narendran 4,5 & Renuka Dias 1,6
1Department of Paediatric Endocrinology, Birmingham Children’s Hospital, Birmingham, United Kingdom; 2Cancer Research UK Clinical Trials Unit (CRCTU), Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, United Kingdom; 3Birmingham NIHR Biomedical Research Centre, Birmingham, United Kingdom; 4Department of Diabetes Medicine, Queen Elizabeth Hospital, Birmingham, United Kingdom; 5Institute of Immunology and Inflammation, University of Birmingham, Birmingham, United Kingdom; 6Institute of Applied Health Research, University of Birmingham, Birmingham, United Kingdom
Background: Type 1 Diabetes is associated with high rates of morbidity and mortality due to diabetes-related vascular complications. A key modifiable risk factor is glycaemic control. Despite an improvement in HbA1c levels in young people in the UK, complication rates remain unchanged.
Aim: To explore whether an association exists between ethnicity and/or socio-economic status and vascular complications in young people with Type 1 Diabetes
Methods: Retrospective case note review from 1st April 2021 – 31st March 2024 for young people aged 12- 30 years with a diagnosis of Type 1 Diabetes, of ≥ 3 years duration in 2 large centres in the West Midlands, UK. Data collected included demographics, date of diagnosis, HbA1c, type of insulin regimen and development of vascular complications as per NICE guidance. Data was analysed using binomial generalised linear models. The null model adjusted for duration of diagnosis (years) and HbA1c ( mmol/mol), and the selection variables of interest were ethnicity and index of multiple deprivation (IMD) quintile.
Results: Data was analysed for 425 patients; 52% of white ethnicity and 51% from IMD quintile 1. Retinopathy was the most observed complication (18%). HbA1c levels increased with the duration of diabetes diagnosis. The probability of developing any vascular complication increased with the duration of diabetes diagnosis [odds 1.16 for every year increase in duration (95% CI: 1.10, 1.22)], and HbA1c levels [odds 1.01 (95% CI: 1.00, 1.02) for every 1 mmol/mol increase in HbA1c]. There was a significant reduction in the development of diabetes-related complications between the most deprived IMD quintile, and the second most deprived quintile (-0.56, (95% CI -1.04); P 0.02). Ethnicity had no impact on the development of complications.
Discussion and Conclusion: The population analysed are from the most deprived socio-economic groups and more ethnically diverse compared to UK census data. Our study shows that increasing socio-economic deprivation increases the risk of developing vascular complications independent of duration of diagnosis and HbA1c. Further detailed evaluation of the factors contributing to this finding as well as a personalised approach to caring for the most deprived patients is essential to improve the outcomes for this cohort.
Volume 111
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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