P-459: Impact of socioeconomic status on metabolic control and quality of life in pediatric patients with type 1 diabetes using flash glucose monitoring in Salta, Argentina
M G d L Pacheco, E Bettancourth, M Ayala, F Siufi, M MoralesAbstract
Introduction
Type 1 diabetes (T1D) is a prevalent chronic condition in children, where technology like Flash Glucose Monitoring (FGM) has changed treatment paradigms. However, social determinants of health, can create structural barriers that compromise the effectiveness of these technological tools.
Objectives
The study aimed to determine the association between socioeconomic status (SES), metabolic control, and quality of life (QoL) in pediatric T1D patients using FGM at the Hospital Público Materno Infantil (HPMI). Specific objectives included characterizing SES using the Graffar method and evaluating metabolic metrics and QoL scores.
Methods
This observational, analytical, and cross-sectional study included 18 pediatric patients with T1D using FGM. Variables included SES (Graffar strata), metabolic metrics (HbA1c, Time in Range [TIR], Time Above Range [TAR], Time Below Range [TBR], and glycemic variability), and QoL (PedsQL 3.2 Diabetes Module). Statistical analysis was performed using Python, employing Spearman’s correlation and comparison by strata.
Results
No patient achieved the HbA1c goal of <7%, with a mean HbA1c of 8.84% and a mean TIR of 48.89%. Patients in the lowest socioeconomic strata (IV and V) showed a marked deterioration in TIR (34.7% for stratum V) and higher glycemic variability. Regarding QoL, the “Worry” dimension was the most affected (mean 43.93). A higher number of Day Hospital consultations was observed in stratum V (8.33) compared to stratum III (6.5), indicating intensified educational efforts for more vulnerable patients.
Conclusions
Socioeconomic status is a critical determinant of metabolic control at HPMI, where poverty strata present significantly lower TIR and higher variability. While FGM technology is valuable for safety, it is insufficient to reach international metabolic goals in vulnerable populations without addressing structural barriers. Educational interventions currently act as a containment network but face limitations due to the patients’ environmental deficiencies