664-P: What Do Youth with Type 1 Diabetes (T1DM) and Caregivers Know about Cardiovascular Disease (CVD) Risk and Reduction?

Risk factors for CVD, the leading cause of premature death in adults with T1DM, are under-recognized and/or undertreated in youth with T1DM, suggesting a need for enhancing prevention and early self-management education efforts. As a first step, this cross-sectional study was conducted to learn about youth with T1DM and their caregivers’ understanding of CVD in relation to DM. Teenagers and young adults with T1DM (n=80; 18.1±1.5y, 41% female, 86% white) attending a DM clinic at a large pediatric academic center and their caregivers (n=64) were surveyed about CVD-DM awareness and self-management practices. Clinical indicators of CVD risk (hemoglobin A1c (HbA1c), blood pressure (BP), and lipid profile) were extracted from medical records. Only 24% youth and 41% caregivers reported that anyone had ever talked to them about the connection between DM and CVD, with the most frequent source being doctors. Merely 14% of youth and 27% caregivers reported having a good/very good understanding of the connection between DM and CVD. Interestingly, 71% of youth and 81% caregivers correctly listed CVD prevention behaviors (e.g., healthy eating, being active), with 35% youth and 44% caregivers listing actions specific to DM care (e.g., good blood glucose control). Most youth and caregivers correctly identified the recommended testing frequency for HbA1c (81% and 78%) and BP (81% and 86%), with fewer youth familiar with the annual testing of lipid profile (41%). A majority of youth and caregivers also correctly listed recommended target values for HbA1c (70% and 77%), but fewer knew target values for BP (25% and 49%) and LDL cholesterol (6% for both groups). In comparison, percentage of youth meeting recommended targeted values for clinical indicators of CVD risk were 29% for HbA1c, 45% for BP, and 70% for LDL cholesterol. These results strongly support a need to raise awareness and address CVD risk and reduction practices as part of ongoing diabetes self-management education.