4-OR: Racial/Ethnic Disparities in Diabetes Self-Care in Young Adults (YA) with Type 1 Diabetes (T1D) Free

Background: Racial/ethnic disparities in diabetes self-care among YA with T1D may contribute to worse outcomes. We conducted a secondary data analysis of the Young Adult Racial Disparities in Type 1 Diabetes (YARDD) study to determine racial-ethnic differences in self-care and contributory factors.

Methods: The YARDD study recruited a diverse cohort of YA with T1D aged 18-28 years from six diabetes centers across the U.S. and collected cross-sectional information on sociodemographics, social determinants of health, clinical factors, psychosocial variables, and diabetes self-care. We performed multivariable linear regression to examine the association of race/ethnicity with a measure of diabetes self-care (Self-Care Inventory Revised (SCI-R)), and related factors.

Results: We included 299 YA with T1D: median age 20 years (IQR 19-22); 55% female (n=162); 33% each non-Hispanic White, non-Hispanic Black, and Hispanic. Compared with White YA, Black YA reported slightly lower SCI scores (B= -6.81/100, P=0.006), while Hispanic YA reported similar scores (B=-1.33/100, P=0.58). In multivariate analyses, race/ethnicity accounted for little variability in SCI score (adjusted R-squared=0.02), while age, sex and diabetes distress explained significant variability (adjusted R-squared=0.24). Diabetes distress scores on the Diabetes Distress Scale were slightly higher in Black YA than Hispanic or White YA (B= 0.38/6.0, P=0.01).

Discussion: In this large national study of YA with T1D, race/ethnicity was not independently associated with differences in diabetes self-care after accounting for demographic, social determinant, psychosocial, and clinical factors. However, diabetes distress was slightly higher among Black YA with T1D and had a strong association with diabetes self-care, providing a potential race-specific target for intervention.