For many youth with diabetes, school provides a structured and supervised environment for diabetes management. Cyber school is a recent alternative in many states with variable supervision. To our knowledge, no information is available on characteristics of youth with diabetes enrolled in cyber school. We identified 142 youth followed in a large academic diabetes center between 2014-2018. Medical records were reviewed for demographic, anthropometric, clinical, and laboratory data from their first visit after cyber enrollment. The vast majority, 130 (92%), had T1D and were white, 127 (90%). Mean age was 14.0±3.4 years with a duration of diabetes of 5.1±4.3 years. Most, 74 (53%), entered cyber in grades 9-12. Reasons for enrollment were documented for 91 (64%), with medical concerns being the most common, 28 (31%). Forty percent were overweight or obese. Most were managed with multiple daily injections, 104 (73%), compared with insulin pumps, 32 (23%), or other regimens. Very few, 8 (6%), utilized continuous glucose monitors. Mean hemoglobin A1c (HbA1c) for those diagnosed two or more years was 9.4±2.1%, and only 17, (18%), of those youth met the glycemic target of a HbA1c ≤ 7.5%. Dyslipidemia (LDL-cholesterol >100 mg/dL) was highly prevalent at 37%; of those, mean LDL was 131±22 mg/dL. Depression was present in 38/84 (45%) screened youth over age 12 years. Missed clinic visits were common; 76 (54%) missed two or more visits in the 12 months before or after enrollment. Mean HbA1c was significantly higher in those missing two or more visits compared with 0-1 visits (9.4±0.3 vs. 8.0±0.3, p-value<0.01), adjusting for age and duration of diabetes. Mean HbA1c increased with additional visits missed. To our knowledge, this is the first description of youth with diabetes in cyber school. They were characterized by poor glycemic control, limited use of devices, a high prevalence of comorbidities, and poor follow-up. This represents a unique group of high-risk patients who may benefit from additional interventions to ensure adequate follow-up.


C. March: None. L.M. Siminerio: None. E. Miller: None. I. Libman: Consultant; Self; Novo Nordisk Inc.

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