O-33: Sociodemographic profile of children and young adults with type 1 diabetes in Kenya: establishing a baseline for equity in care
J Kimetto, C Lagat, N Ngugi, G Gathecha, E Onyango, P Wamalwa, E Makena, C Karekezi, E Omondi, S Marwa, O Nabeta, V Nabeta, N H Yayah JonesAbstract
Introduction
Children and young adults with type 1 diabetes(T1D) in Kenya experience persistently suboptimal glycemic outcomes, yet large-scale data describing the sociodemographic and care context needed to design equitable, context-responsive diabetes services to improve clinical outcomes remain limited.
Objectives
To describe the sociodemographic profile and care context of children and young adults living with T1D in Kenya.
Methods
Cross-sectional analysis of 3,847 participants aged <25 years across 46 clinics in 35 counties. Structured questionnaires captured demographic characteristics, household conditions and care context, including access to diabetes services.
Results
Mean age was 17 years (female 49.7%, male 50.3%). Mean HbA1c was 11.14% (median 11.30%, IQR 9.10–14.00), with 92.7% above target. 46.1% resided in rural areas; 62.3% relied on public transportation, and 40.6% required 30–60 minutes to reach clinic. Indicators of household vulnerability included 41.6% of caregivers reported income <USD 77/month, 25% reported fewer than three meals per day, and 68.6% lacked refrigeration. Caregivers were primarily mothers (67%); 70% of fathers were in informal employment, 84% were literate, and 94% of households had mobile phones. Despite high access to clinic-based care and insulin, gaps persisted in diabetes education, nutrition support, and counseling, with 38.3% requiring assistance to understand diabetes care. These patterns varied across counties, highlighting heterogeneity in living conditions and access to T1D services.
Conclusions
These findings highlight suboptimal glycemic control within a context of food insecurity, uneven access to multidisciplinary T1D services, and geographic barriers to care. They describe opportunities for the Kenyan health system to leverage mobile connectivity, caregiver literacy, and existing clinic platforms to deliver tailored, equity-focused diabetes care and improve outcomes.