742-P: Socioeconomic Position (SEP) Attributes Intersect with Race to Influence Glycemic Control Patterns in Youth with Type 1 Diabetes (T1D) over Time

Abstract

SEARCH for Diabetes in Youth has identified racial/ethnic disparities in patterns of glycemic control among T1D youth. How SEP and race/ethnicity intersect to influence these disparities is poorly understood. SEARCH T1D participants (n=1,313) age ≤20 years at diagnosis (dx) in 2002-5 were followed 6-13 years with 3+ hemoglobin A1c measures. Group-based trajectory modeling of A1c identified Group 1 (G1, 77%): lower A1c with mild increases (from mean 7.4 to 8.4%) and Group 2 (G2, 23%): high and increasing A1c (from 8.5 to 11.2%). Classification and regression tree analysis modeled patterns in 8 demographic and SEP attributes that distinguished between G2 and G1 (prediction accuracy 0.68). Race/ethnicity was most influential in predicting G2, with 39.6% G2 in minorities vs. 18.2% in non-Hispanic whites (NHWs) (Figure). Among minorities, 52.5% of those with public insurance were in G2 vs. 32.4% of those with private insurance. Among NHWs without college-educated parents, older age at dx (≥10 years) was associated with G2 (34.0% vs. 20.5% in dx <10 years). Among NHWs with college-educated parents, living in a 1-parent household was associated with G2 (23.6% vs. 8.9% in a 2-parent household). Race/ethnicity intersects differentially with select SEP attributes for NHW vs. minorities suggesting more nuanced studies of health disparities are needed. Disclosure A.D. Liese: None. B.A. Reboussin: None. A.R. Kahkoska: Other Relationship; Self; Novo Nordisk A/S. E.A. Frongillo: None. F. Malik: None. G. Imperatore: None. S. Saydah: None. A. Bellatorre: None. J.M. Lawrence: None. D. Dabelea: None. J.A. Mendoza: None. Funding National Institutes of Health (1R01DK117461, 1UC4DK108173)