433-P: Status of Type 2 Diabetes among Young Adults in Community Health Centers

Early onset Type 2 Diabetes (T2D) is characterized by earlier complications, but little is known about DM care in young adults with T2D in community health centers (CHCs). Using electronic health record data from a national CHC network, we examined sociodemographic characteristics, care patterns (i.e. medications, technology use), glycemic control and complications among young adults with T2D. We used logistic regression to identify factors associated with newer cardiovascular-DM medication use and complications. The cohort included 9,604 patients, 18-39 years, seen 1/3/2008-8/2/2023: 53% Hispanic, 26% Black (Table 1). Use of newer medications and insulin were as follows: GLP-1: 17%, SGLT-2: 12%, Insulin: 38%. Rates of microvascular or macrovascular complications were high both in those 18-29 (11% and 9%) and 30-39 years old (16% and 11%). Newer agent prescriptions (GLP-1 or SGLT-2) were less common among Hispanic and Black patients than Non-Hispanic and White patients [OR 0.84, (CI 0.73-0.96, p =0.01) and OR 0.66, (CI 0.56, 0.77, p < 0.001), respectively]. Hispanic patients also had higher odds of complications (microvascular or macrovascular) than Non-Hispanic patients [OR 1.23 (CI 1.08, 1.42), p=0.003]. Complications are common among young adults with T2D, yet prescription of novel agents is low. These findings highlight the translation gap in care for young adults with T2D and the need to understand drivers of care inequities.