ESPE Abstracts (2014) 82 P-D-2-3-353

Household Unemployment and Low Levels of Education are Associated with Poor Glycaemic Control in Children and Young People with Type 1 Diabetes Mellitus

Louise Apperley & Sze May Ng

Paediatrics, Southport, UK

Background: Socioeconomic deprivation, obesity and emotional well-being are important determinants of health inequalities and poor glycaemic control in adults with type 1 diabetes mellitus (T1DM).

Objectives: This study aims to look at the effect of social deprivation, BMI and patient reported emotional well-being on glycaemic control in children and young adults with T1DM.

Methods: Socioeconomic status was measured by cross-referencing postcodes with indices of multiple deprivation (IMD) 2010 from records of 124 T1DM patients aged 1–16 years. 32 484 small geographic areas (lower super output areas) in England are ranked from 1 (most deprived) to 32 482 (least deprived). The mean BMI standard deviation scores (SDS) were determined and adjusted for age and sex. The World Health Organization-5 Well-Being Index (WHO-5) were used as a measure of psychological emotional well-being obtained for each patient. Data was analysed using statistical software Statistical Package for the Social Sciences (SPSS 20.0). The Spearman rank correlation coefficient looked at associations between HbA1c (mmol/mol), IMD indices, BMI SDS and WHO-5 well-being index scores.

Results: Records from the 124 (63F:61M) patients with T1DM showed that the mean age of diagnosis was 8.2 years (S.D. 4.1), range 1–16 years. Average HbA1c was 68.1 mmol/mol (S.D. 15.1). Poor glycaemic control were significantly associated with lower levels of education (r=−0.22, P=0.02) and unemployment (r=−0.19, P=0.04). Significance was not reached for level of income (r=−0.16, P=0.07) and overall deprivation (r=−0.17, P=0.06). There were no associations between HbA1c and BMI SDS or emotional well-being.

Conclusions: This study shows that household level of education and employment were important factors to achieving good glycaemic control in children and young adults with T1DM. It will be important to health policy makers to give focus to those of lower socioeconomic backgrounds in planning potential interventions for better diabetes control in children and young people.

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