Objective: A subset of youth with chronic medical conditions, including T1D, are unresponsive to typical medical and behavioral health interventions, often resulting in avoidable acute health problems such as DKA. This study examines how youth with T1D who are unresponsive to standard care compare to similarly referred youth with other chronic medical conditions.

Methods: Participants were referred by medical providers due to lack of response to standard care - as evidenced by avoidable ED visits and/or lab values chronically out of range - including 50 youth with T1D and 54 with other chronic medical conditions, such as cystic fibrosis, end-stage renal disease, and seizure disorder. Retrospective chart reviews collected presence and frequency of social risks. Mean age was 14.5 years; 48% were female; 85% were non-Hispanic White.

Results: Social risk prevalence was high across medical conditions (see Figure).Youth with T1D were significantly more likely to have experienced multiple social risks, such as difficulty attending school, DHS involvement, and drug/alcohol abuse by youth and caregivers.

Conclusions: When compared to youth struggling with self-management of other chronic conditions, youth with T1D experienced significantly higher prevalence and frequency of social risks. Interventions developed for this vulnerable population should include components that directly target these important social factors.


D.V. Wagner: None. A. Hartman: None. C. Jenisch: None. I. Guttmann-Bauman: None. H. El-Mansy: None. M.A. Harris: None.


The Leona M. and Harry B. Helmsley Charitable Trust

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