P-454: Clinical and demographic characteristics, experience with diabetes education and barriers to care for children, adolescents and young adults living with diabetes in Liberia
A Perkins, D Cohen, H Koon, D Hoff, R Hunter, J Karmon, N Kollie, F Wakarwee, S James, J Maniam, C Eigenmann, G D OgleAbstract
Introduction
The increasing burden of type 1 diabetes worldwide is felt most acutely in resource constrained settings where access to and affordability of care are limited. Little is known about the state of diabetes among children and adolescents in Liberia despite an urgent need for such data to ensure the provision of just and equitable care, fill gaps in clinician and patient knowledge, strengthen advocacy efforts, and inform resource distribution.
Objectives
To describe the demographic and clinical characteristics, experience with diabetes education and barriers to care among children and adolescents receiving diabetes care at Life for a Child (LFAC) clinics in Liberia.
Methods
We conducted a descriptive, multi-center study at the five LFAC supported hospital-based clinics in Liberia. Existing data collection tools were adapted to include additional variables of interest. Data was collected once for each individual presenting between May and September 2025. Descriptive analyses were performed for children and adolescents with an age of <19 at time of clinical diagnosis of type 1 diabetes.
Results
One hundred eleven participants (49.5% female) were included (Table). The most frequently covered education topics were hypoglycemia management, healthy eating, and injection sites. The largest education gaps were in coping skills and sick day management. Barriers to care included poor understanding of diabetes management (51%), poverty (49%) and lack of social support (33%).
Conclusions
Children and adolescents receiving care at LFAC Liberia clinics are clinically high-risk due to HbA1c elevation and a substantial burden of diabetic ketoacidosis and severe hypoglycemia. Blood glucose data were not consistently available, limiting clinician’s ability to make insulin adjustments. Education gaps and barriers to care suggest an unmet need for tailored educational and social support.