Type 2 diabetes mellitus (T2D) in youth has become an increasingly pressing issue over the last two decades. Emerging data from adult studies show associations between T2D and neighborhood characteristics; less is known about these effects on the pediatric population. We performed a retrospective study on youth ages 7 to 21 years with T2D seen at our health care system from 1/1/20to 4/1/2021. Utilizing United States government databases, we categorized zip codes of the primary residences based on neighborhood risk factors: food deserts (paucity of healthy food) , food swamps (abundance of unhealthy food) , rural, medically underserved (shortage of primary health care services) , or low-risk. This study included 396 youth; 51% live in an area with at least one neighborhood risk factors. Compared to those living in low-risk neighborhoods (age 14.6 ± 2.6 years, A1c 9.2 ± 2.6 %) , youth living in rural areas tended to be younger at initial diagnosis (14.1 ± 2.9 years) with higher initial A1c (9.4 ± 2.6%) , though the effect size was smaller than what this study was powered to detect. Youth living in food deserts or medically underserved areas also tended to be younger at initial diagnosis (14.2 ± 2.6 years and 14.2 ± 2.9 years, respectively) compared to youth in low-risk neighborhoods. A better understanding of neighborhood risk factors may help to inform public health policies with the goal of mitigating the rise and severity of pediatric T2D.


J.Ni: None. A.Addala: None. D.M.Wilson: Advisory Panel; Tolerion, Inc., Other Relationship; Intrexom T1D Partners, Research Support; National Institutes of Health. P.Prahalad: None.

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