P-354: From HbA1c to housing: an audit of medical and social determinants of health in youth-onset type 2 diabetes
P Stewart, D LongmoreAbstract
Introduction
The incidence of type 2 diabetes mellitus (T2D) in youth is increasing globally. Early onset T2D is associated with significant long-term multi-organ morbidity and mortality. Complication rates of diabetes are commoner and present earlier in this cohort compared to individuals with type 1 diabetes mellitus. Ethnicity, family history and lower socioeconomic status are associated with poorer long term outcomes. Patients with T2D require close monitoring to prevent, detect and manage potentially life threatening end organ damage
Objectives
Our aim was to collate data on characteristics of patients diagnosed with T2D at the Royal Children’s Hospital (RCH) Melbourne with a view to informing future service and workforce planning to optimise outcomes.
Methods
A retrospective audit of patients currently attending the RCH T2D service. There was retrospective verification of the data with complete case ascertainment. Demographic, metabolic and non-metabolic characteristics are presented as mean (range) and percentage.
Results
63 patients were assessed.Family history of a first degree relative with T2D was present for 71%. Mean age at diagnosis was 13.16 (7-16.66) years. Median glycated haemoglobin for individuals decreased over time (6.8% to 6.25% by year 2) with percentage in the non-diabetes range (<6%) increased from 25% to 41% over the first-year post diagnosis and 38.2% in year 2. BMI increased from baseline but overall median BMI remained in a narrow range (35-37kg/m2). Prevalence of hypertension was 8%, microalbuminuria 15%, metabolic dysfunction associated steatotic liver disease (MASLD) 42% and dyslipidaemia 33%. Social challenges were prevalent.
Conclusions
Optimising health and wellbeing outcomes for young people living with T2D will require monitoring and management of glycaemia, alongside early intervention to address diabetes-related complications. Social difficulties are highly prevalent in this population, and improving outcomes will necessitate targeted support for these social determinants of health.