P-188: Social connection and glycemic control in Kenyan youth with type 1 diabetes. insights into psychosocial determinants of self-management
K Maureen, C Lagat, E Omondi, J Kimeto, J Njunguru, G GathechaAbstract
Introduction
The ISPAD 2026 Guidelines emphasize psychological care as integral to pediatric diabetes management. In sub-Saharan Africa, where 92% of youth with T1D have poor glycemic control, the role of social support remains underexplored at the population scale.
Objectives
To describe psychosocial burdens and test whether having someone to discuss diabetes with is associated with improved glycemic control among Kenyan youth with T1D.
Methods
Cross-sectional analysis of 3,847 participants aged <25 years across 46 CDiC clinics in 35 Kenyan counties was done. Structured questionnaires assessed anxiety, social support, bullying, support group membership, and HbA1c. Associations were tested using chi-square and Wilcoxon rank-sum tests; multivariable logistic regression was used to adjust for confounders.
Results
Mean HbA1c was 11.1%; 7.3% achieved target control. Psychosocial burden was substantial: 43.6% felt anxious or sad about their condition, 32.8% feared passing T1D to children, and 14.7% had been bullied at school (associated with worse control, p=0.025). Conversely, 75.6% had someone to talk to about diabetes, and this was associated with better glycemic control (7.9% good control vs. 6.3% without someone, p=0.009). Despite 68.5% not belonging to support groups, 84% of these expressed desire to join. In multivariable analysis, having someone to talk to showed a protective trend (adjusted OR 0.77, 95% CI 0.51–1.02, p=0.067). Lower control was independently associated with longer diabetes duration (OR 1.13/year, p<0.001) and prior DKA episodes (OR 1.83, p=0.003).
Conclusions
Social support is a promising, underleveraged protective factor for glycemic control in Kenyan youth with T1D. The high unmet demand for peer support groups (84%) presents an actionable target. Integrating structured peer support and mental health services into CDiC clinics could address the psychosocial drivers of the 92.7% poor control crisis in the region.