THU152 HbA1c Control Of Pediatric Patients With Diabetes In The Urban Community Hospital Representing Underserved, Minority Population: Can The Frequent Encounters With Multi-Disciplinary Diabetes Team Overcome Patient-Related Adverse Variables In Improving Their Glycemic Control?
Authors: Velasquez Sara , Ozcan Ozan , Dave-Sharma Swati 
Published: October 2023

Disclosure: S. Velasquez: None. O. Ozcan: None. S. Dave-Sharma: None.

Introduction: The American Diabetes association’s established goal for HbA1C across all age groups is as &lt;7%. As the prevalence of diabetes continues to increase, its control in the pediatric population has become more challenging. Studies have shown controlling diabetes is especially challenging in minority ethnic groups of low income neighborhoods. Our hospital, located in the Mott Haven community, serves the minority population of mostly Hispanics and Blacks with an average household income of &lt; $ 20 000 (poverty rate 39%). Objectives: This study aimed to identify different variables among patients with controlled and uncontrolled HbA1c in our unique pediatric population. Our goal was to learn from the group of patients with good diabetes control to improve the control of patients with poor glycemic control by changing the protocols involving our multi-disciplinary care team. Results: We collected data from 86 patients with diabetes (type 1 and 2) from our pediatric endocrinology clinic and divided them into 3 groups based on their HbA1c levels. 1. Good control: HbA1c &lt;7.5 % in 33/86 (38%) patients, 2. Poor control: HbA1C 7.5%-10% with 34/86 (40%), and 3. Very poor control: HbA1C &gt;10% with 19/86 (22%) patients. We studied the data for variables such as gender, age, ethnicity, insurance, type of diabetes, duration of diabetes, BMI, frequency of encounters with the multi-disciplinary team, and more. Of 86 patients, the average age was 15.65 (51% were females, and 49% were males). 43% had type 1 diabetes, and 57% had type 2 diabetes. The type 1 vs. Type 2 diabetes ratio among different groups was 12% Type 1 vs. 88% type 2 in the group with good control, 73.5% Type 1 vs. 26.5% Type 2 in the poor control group, and 42% type 1 vs. 58% type 2 in the group with very poor control. Obesity was found in 50% of our patients; in the good control group, it was 57%. In the poor control group, 38%, and in the very poor control group, 58%. A correlation study run between the HbA1c levels and duration of diabetes found significantly correlated (R 0.38) in the good control group. Other groups were found positively correlated yet found statistically insignificant. Conclusion: We found that Type 2 Diabetes with Obesity was more prevalent than Type 1 in our pediatric population. Patients with poor and very poor diabetes control had a longer duration of diabetes compared to patients with good control. Frequent visits with the diabetes team improved HbA1C in our patients. 84% of patients in the good control group were seen by the diabetes team more frequently (at least every 3-6 months) compared to patients with higher HbA1c. The group with very poor glycemic control patients were more obese with Type 2 Diabetes and were less frequently coming for the scheduled appointments. More efforts must be made to design the protocols to overcome patient-related obstacles to improve diabetes control.

Presentation: Thursday, June 15, 2023