P-59: Role of race, ethnicity and socioeconomic status on diabetes distress in adolescents and young adults with type 1 diabetes: a scoping review
S Ojukwu, M Reynolds, L Volkening, L LaffelAbstract
Introduction
Youth with diabetes from lower socioeconomic status (SES) and/or from racial/ethnic minority groups often have suboptimal diabetes outcomes. Diabetes distress has also been linked to worse diabetes outcomes. Lowering diabetes distress may be a modifiable factor that can improve glycemic control.
Objectives
We aimed to identify and describe diabetes distress in adolescents and young adults (AYA) with type 1 diabetes (T1D) from racial/ethnic minority groups and among those with low SES.
Methods
We conducted a scoping review, following the PRISMA-ScR guidelines, by searching Medline, Embase, CINAHL and Web of Science for peer-reviewed articles published in English. For inclusion, studies had to be in AYA who were 10-30 years old with T1D and had to include analyses of diabetes distress by race/ethnicity and/or SES. Two reviewers independently screened abstracts with a third reviewer resolving conflicts.
Results
Of 380 articles, 16 were included. Generally, the studies showed that racial minorities had higher levels of diabetes distress, both by youth and parent reported measures. However, diabetes distress was not increased in 80% of studies analyzing Hispanic AYA. Lower socioeconomic status, measured various ways, such as by education, income and deprivation index, was largely associated with higher diabetes distress both in youth and parent reported diabetes distress measures. Overall, 87.5% of studies were conducted in the United States. PAID was the most frequent diabetes distress measure utilized.
Conclusions
In this scoping review, diabetes distress was higher in AYA with T1D from racial minorities and in those with lower SES; however, Hispanic AYA with T1D did not report higher diabetes distress. Studies have mainly described the prevalence of diabetes distress but have not conducted in-depth analysis to understand the underlying rationale. Further research among AYA with T1D is needed to develop evidence-based interventions to reduce diabetes distress in racial/minority AYA and in those with lower SES.