P-53: Sociodemographic profile of children and young adults with type 1 diabetes in Uganda

Introduction

Children and young adults with type 1 diabetes (T1D) in Uganda experience persistently suboptimal glycemic outcomes, yet large-scale data describing the broader social and care environment needed to design context-appropriate diabetes services to improve clinical outcomes remain limited.

Objectives

To characterize the sociodemographic profile and care environment of children and young people with T1D in Uganda.

Methods

Cross-sectional analysis of 2,235 participants aged 6 months to 25 years across a national network of 32 clinics in Uganda. Structured questionnaires captured demographic characteristics, household conditions, and the care environment, including access to diabetes care services.

Results

Mean age was 17.9 years (SD 4.85); 49% were female. Glycemic control was poor, with a mean HbA1c of 10.5% (SD 2.8); 89% of participants had HbA1c above target (>7%). Average duration of diabetes was 5.0 years (SD 4.0). Participants attended a mean of 9.4 clinic visits per year (SD 4.7). Access to care appeared challenging, with the majority (56%) walking to the clinic and a median travel distance of 26 km (IQR 10–60).

Caregiver employment was low (85% unemployed), and 56% had a primary education or less. Food insecurity was common, with 36% reporting reduced food intake and 24% going a full day without food. Chronic undernutrition was evident, with 25% stunted and 11% underweight.

Housing conditions included 44% living in low-quality or informal housing and 17% reporting concern about housing stability. Only 24.6% of households had access to refrigeration.

Conclusions

Children and young people with T1D in Uganda manage their condition within a context of substantial social and economic constraints, despite strong engagement with clinic-based care. This suggests that clinical access alone is insufficient when core social and household conditions required for daily diabetes management are not met.