744-P: Racial Differences in the Contribution of Sociodemographic, Clinical, and Self-Care Factors on Glycemic Control in Adults with Type 2 Diabetes

Abstract

Background: This study evaluated the unique contribution of demographic, social determinants, clinical and self-care factors on glycemic control in a sample of adults with T2DM. Methods: This analysis used data obtained from 615 adults with T2DM in the Southeastern U.S. Linear regression models were used to assess the incremental contribution of key variables (demographic, social determinants [socioeconomic status, psychosocial and built environment factors], clinical and self-care factors) at varying levels of influence, on glycemic control, after stratifying by race. Results: For the entire sample, there were significant relationships between glycemic control and age (β = −0.02, p < 0.05), Medicaid (β = −0.69, p < 0.05), diabetes fatalism (β = −0.02, p < 0.05), self-efficacy (β = −0.10, p < 0.001), social support (β = 0.01, p < 0.05), comorbidity (β = −0.09, p < 0.05), insulin use (β = 0.95, p < 0.001), and being a former smoker (β = 0.35, p < 0.05). In the stratified regression model for Non-Hispanic Whites (NHW), there were significant relationships between glycemic control and Medicare (β = −1.27, p < 0.05), “other” insurance type (β = −1.53, p < 0.05), education (β = −0.95, p < 0.05), self-efficacy (β = −0.06, p < 0.001), neighborhood rating (β = −0.58, p < 0.05), neighborhood comparison (β = 0.39, p < 0.05), insulin use (β = 1.04, p < 0.01). In the stratified regression model for Non-Hispanic Blacks (NHB), there were significant relationships between glycemic control and age (β = −0.02, p < 0.05), diabetes distress (β = 0.44, p < 0.05), self-efficacy (β = −0.11, p < 0.001), social support (β = 0.01, p < 0.01), comorbidity (β = −0.13, p < 0.05), and insulin use (β = 1.02, p < 0.001). Conclusion: In this sample of adults with diabetes, there were racial differences in demographic, psychosocial, built environment and clinical factors associated with glycemic control. Interventions may need to be tailored by race or ethnicity to achieve optimal outcomes. Disclosure O. Olukotun: None. J.S. Williams: None. S.L. Walker: None. O.J. Akinboboye: None. L.E. Egede: None. Funding National Institute of Diabetes and Digestive and Kidney Diseases (K24DK093699, R01DK118038, R01DK120861 to L.E.E.); National Institute for Minority Health and Health Disparities (R01MD013826 to L.E.E., S.L.W.)