Endocrine Abstracts

Background & Aims: While national audits show improving glycaemic control in paediatric T1DM many children, particularly those from socially vulnerable backgrounds, still fail to meet recommended targets. This project aimed to identify psychosocial factors associated with poor glycaemic control and reduced healthcare engagement.

Methodology: A retrospective review was conducted of 60 paediatric T1DM patients in a south London tertiary centre. Patients were assessed using multiple variables including age, gender, HbA1c, BMI, hospital admissions, missed appointments, safeguarding involvement, interpreter need, and psychological support referrals.

Results: 58% of boys and 63% of girls had HbA1c levels above the national target, with a cohort average of 67 mmol/mol, exceeding the 60 mmol/mol reported by the 2022/23 NPDA audit. Children referred to social services experienced the highest rates of hospital admissions and DNAs, followed by those requiring interpreter or psychological support. These findings suggest that both external (social and language barriers) and internal (mental health) factors contribute to reduced engagement and poorer outcomes. Moreover, children from Black, Asian and Minority Ethnic (BAME) backgrounds had higher admission rates and missed appointments than White British peers, echoing national trends in ethnic healthcare disparities.

Conclusion: This evaluation highlights the complex interplay between psychosocial vulnerability and poor glycaemic outcomes in paediatric T1DM. Social instability, mental health needs, language barriers, and ethnicity appear to significantly affect disease management and healthcare engagement. These findings reinforce the importance of early holistic, culturally sensitive care and ensuring there are integrated psychosocial services in diabetes teams. They also raise awareness to diabetes teams of the importance of addressing health inequalities to minority ethnic groups and those from areas of social deprivation. Reports have shown the role of family support and youth workers in this patient population is vital in bridging these gaps and disparities. Ensuring this is addressed before transition may reduce complications, DNAs, and long-term strain on adult diabetes services. Future work will include statistical analysis and expanding the sample size to further validate these findings and create statistical inference.