P-180: Psychosocial and socioeconomic determinants of glycemic outcomes among children and young adults with type 1 diabetes in Uganda
T Piloya Were, C Nyangabyaki, O Nabeta, R Namwanja, R Kigozi, D Mubangizi, K Bowers, V Nabeta, N Yayah JonesAbstract
Introduction
Glycemic outcomes among children and young adults with type 1 diabetes (T1D) in sub-Saharan Africa remain suboptimal. While social determinants of health are recognized as important, the relationship between these factors and glycemic outcomes in this population remains understudied.
Objectives
To identify psychosocial and socioeconomic determinants of glycemic outcomes among children and young adults with type 1 diabetes in Uganda.
Methods
A cross-sectional analysis was conducted across 32 diabetes clinics in Uganda, including 2,235 participants aged 6 months to 25 years. Multivariable linear regression was used to evaluate associations between HbA1c and selected psychosocial and socioeconomic variables, including caregiver employment, caregiver education, food insecurity, and access to a mental health worker, adjusting for age, gender, diabetes duration, clinic, and frequency of clinic visits.
Results
Median HbA1c was 10.3% (IQR 8.4–12.5) with 89% of participants having HbA1c above target (>7%). In the adjusted model, caregiver employment (β −0.55, 95% CI −0.88 to −0.22) and access to a mental health worker (β −0.52, 95% CI −0.76 to −0.28) were associated with lower HbA1c while high food insecurity (β 0.71, 95% CI 0.30 to 1.11) and lower level of caregiver education (β 0.71, 95% CI 0.28 to 1.14) were associated with higher HbA1c.
Conclusions
Glycemic outcomes among children and young adults with T1D in Uganda are influenced by psychosocial and socioeconomic factors, including caregiver employment, education level, food insecurity, and access to mental health support. These findings highlight the importance of addressing social and psychosocial context alongside clinical care in this population.