Disparities in diabetes technology utilization in youth with diabetes
Authors' conclusion
There are marked disparities in diabetes technology use among youth with diabetes. Findings from the provider surveys showed reliance on subjective variables as opposed to objective criteria. Youth with diabetes and caregivers of underrepresented race/ethnicities learned about diabetes technology later and were less likely to use technology. Though clinic providers perceived multiple barriers to technology utilization, responses from families showed low perceived burden and highly positive attitudes.
Study context
- Population
- Youth with diabetes at a large urban pediatric hospital; surveys of providers, English- and Spanish-speaking patients aged 8–17 years and caregivers
- Exposure
- Non-Hispanic Black (NHB) and Hispanic vs non-Hispanic White (NHW) youth with T1D
- Outcome
- Pump therapy and CGM use in youth with T1D, independent of insurance payor status
- Follow-up
- August 2020 to 2021
Methodological detailsclinical database analysis, provider, patient and caregiver surveys, single urban pediatric hospital, Surveys: 16 attending physicians, 5 fellow physicians, 5 nurse practitioners, 13 diabetes educators; patients (n=109) and caregivers (n=117)
- Clinical database analysis
- Provider, patient and caregiver surveys
- Single urban pediatric hospital
- Surveys: 16 attending physicians, 5 fellow physicians, 5 nurse practitioners, 13 diabetes educators; patients (n=109) and caregivers (n=117)
Main finding
As reported in the abstract
OR
- NHB · pump therapy
- 0.4
- Hispanic · pump therapy
- 0.35
- NHB · continuous glucose monitors (CGM)
- 0.74
- Hispanic · CGM
- 0.54
Observational data: associations, not effects.
Further findings
| Outcome | P value |
|---|---|
| Importance of subjective factors (parental education, health literacy, psychosocial stability) for pump eligibilityDiabetes educators vs Physicians · higher importance with diabetes educators | P < 0.05 |
Timing of learning about diabetes technology after diagnosis
- Hispanic and NHB patients and parents learned about diabetes technology later after diagnosis vs NHW patients/caregivers
Perceived barriers to CGM use
- Physicians and diabetes educators, but not patients, identified patient-perceived barriers (embarrassment and/or discomfort wearing devices) as reasons for not using technology
Original publication
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