Racial and ethnic disparities in preventive care among adults with type 1 diabetes: findings from the 2022 Behavioural Risk Factor Surveillance System.

Aim: The population of adults with type 1 diabetes mellitus (T1DM) is rising, yet little is known about care for this population. The purpose of this study was to examine racial/ethnic disparities in care among adults with T1DM. Methods: The 2022 Behavioural Risk Factor Surveillance System (BRFSS) was the first year that individuals endorsing diabetes were asked to delineate which type. We examined differences in frequency of A1C monitoring, recency of screening for eye complications, recency of receipt of diabetes self-management education, and status of vaccinations. All models included age, sex and health insurance status as covariates. Results: There was a total of 1050 (0.2%) participants from the BRFSS database who met the inclusion criteria; 34% were minoritised, 52% male, 67% between 31 and 70 years old, 53% had a high school education or less and 89% had health insurance. In complex sample analyses to account for stratification and sampling, non-Hispanic whites (NHWs) were the reference group. An overall pattern emerged of non-Hispanic Blacks (NHBs) and American Indian/Native Americans (AI/NA), and to a lesser extent Hispanics, having lower rates of preventive care measures compared with NHWs. People who identified as NHB had significantly lower rates for some vaccines. Hispanics had worse rates of eye screening. NHBs and AI/NA had fewer A1C checks. In contrast, individuals reporting 'other' race, who were predominantly multiracial, tended to show slightly higher rates of eye screening and diabetes education compared with NHWs. Conclusions: Strategies to ameliorate disparities in preventive care for adults with T1DM are needed. Researchers are encouraged to delineate type of diabetes and to report race and ethnicity data in as granular a fashion as possible, including multiracial respondents.