Endocrine Abstracts

Background: The UK National Paediatrics Diabetes Audit (NPDA) 2025 recently identified notable disparities in health outcomes and increasing inequality in access to diabetes technologies among children and young people (CYP) living in the most versus the least deprived areas.

Aim: This study aimed to assess the impact of social deprivation on adherence to hybrid closed-loop therapy and glycaemic outcomes in CYP with Type 1 diabetes (T1D).

Methods: We carried out a retrospective analysis using continuous glucose monitoring (CGM) metrics alongside socioeconomic data derived from the English Index of Multiple Deprivation (IMD). The IMD is a composite index encompassing seven domains—income, employment, education, skills and training, health and disability, crime, barriers to housing and services, and living environment—used to classify areas from most deprived (rank 1) to least deprived (rank 32,844). Variables analysed included diabetes duration, age, average CGM adherence, CGM-derived metrics, and mean HbA1c at 12 months. Correlation analyses and regression modelling were used to explore associations.

Results: There were significant inverse correlations between deprivation measures and glycaemic outcomes. A higher IMD rank (indicating less deprivation) was significantly associated with lower HbA1c at 12 months (r = -0.26, P = 0.007). Comparable negative correlations were found in IMD sub-domains such as income (r = -0.226, P = 0.01) and education and skills (r = -0.294, P = 0.002), suggesting that improved socioeconomic status was linked to better glycaemic control. In regression modelling, IMD rank emerged as a significant independent predictor of mean HbA1c at 12 months (P = 0.009).

Conclusion: This study demonstrated that glycaemic outcomes were notably poorer in CYP from the most deprived areas, even when treated with hybrid closed-loop therapy. Education and employment levels within households were key determinants of successful glycaemic management in CYP with T1D. These findings are consistent with adult data indicating that socioeconomic deprivation contributes to adverse health outcomes. The study highlights the substantial influence of deprivation on the effectiveness of diabetes technologies and supports the need for targeted strategies and policy reform to improve outcomes for disadvantaged CYP.