Low rate of endocrinology referrals among hyperglycemic hidradenitis suppurativa patients

Summary: Abstract Body: Hidradenitis suppurativa (HS) is associated with metabolic comorbidities, including type II diabetes mellitus (T2DM). HS also disproportionately affects socioeconomically and racially diverse populations, raising concerns about potentially underrecognized metabolic risks. Early detection and referral for endocrinologic care may improve outcomes in HS patients; however, the frequency of such referrals remains unclear. This study examined endocrinology referral rates among HS patients with elevated glucose levels, with a focus on potential racial differences. Using the TriNetX database, we performed a 10-year retrospective analysis of de-identified patient records from a broad range of U.S. healthcare organizations, spanning both insured and uninsured populations. We included HS (ICD-10-CM: L73.2) patients with at least two glucose measurements above 120 mg/dL, without a T2DM diagnosis (ICD-10-CM: E11) prior to or within one month of HS onset. Endocrinology referrals were identified using SNOMED and CPT codes associated with referrals to endocrinology. Racial differences in referral rates were also examined. Among 14,740 HS patients meeting the criteria, only 182 (1.24%) received an endocrinology referral. The HS population was further divided into 7974 White patients and 4664 Black patients. Notably, referral rates varied by race, with Black patients having lower referral rates compared to their White counterparts (0.83% vs. 1.29%; p-value: 0.02). These findings suggest a gap in multidisciplinary care for HS patients, underscoring the need for increased awareness and proactive evaluation of metabolic comorbidities. A reason for lower referral rates in Black patients is unknown but may indicate possible disparities in accessing specialized metabolic care. Targeted interventions—such as providing culturally sensitive patient education, and strengthening interdisciplinary care pathways—could help address these disparities, facilitate earlier detection and management of HS, and ultimately foster more equitable health outcomes. Chunghwan Ro¹, Ana Ormaza Vera¹, Madison P. Olexson¹, Clinton W. Enos¹ 1. Dermatology, Macon & Joan Brock Virginia Health Sciences at Old Dominion University, Norfolk, VA, United States. Clinical Research: Epidemiology and Observational Research