Disparities in technology utilization among youth with type 1 diabetes across diverse racial and socioeconomic backgrounds
Authors' conclusion
In a cohort of commercially insured youth with T1D, both race and income are important factors that can independently influence the use of diabetes technology. Racial disparities decrease with higher income and disappear at incomes ≥US$200,000. Black youth with income <US$40,000 are at the highest exclusion risk from essential technologies. Greater effort is needed at both the system and individual levels to mitigate these disparities.
Study context
- Population
- Commercially insured youth <18 years with T1D, OptumLabs Data Warehouse claims, 2011–2021
- Participants
- 13,246 participants
- Exposure
- Insulin pump and CGM fills by race/ethnicity and household income
- Outcome
- Proportion with a fill for an insulin pump or a CGM, overall and by race/ethnicity and annual household income
- Follow-up
- 2011–2021
Methodological detailsclaims-based, national
- Claims-based
- National
Main finding
As reported in the abstract
- White vs Black · higher with White
- CGM fills 35.8% vs 22.5%; P < 0.001
- White vs Black · higher with White
- pump fills 31.9% vs 21.2%; P < 0.001
- White vs Hispanic · higher with White
- CGM fills 35.8% vs 32.6%; P = 0.047
- White vs Hispanic · higher with White
- pump fills 31.9% vs 25.0%; P < 0.001
- Income <US$40,000 vs Income ≥US$200,000 · lower with income <US$40,000
- CGM fills 25.4% vs 43.8%
- Income <US$40,000 vs Income ≥US$200,000 · lower with income <US$40,000
- pump fills 22.4% vs 38.8%; P < 0.001
- Overall CGM fills
- 36.1%
- Overall pump fills
- 30.9%
Observational data: associations, not effects.
Further findings
| Outcome | Estimate | P value |
|---|---|---|
| CGM and pump fills, income <US$40,000 subgroup: Black vs WhiteBlack vs White · fewer with Black | CGM fills 15.2% vs 27.9% | P = 0.006 |
| CGM and pump fills, income <US$40,000 subgroup: Black vs WhiteBlack vs White · fewer with Black | pump fills 12.9% vs 25.5% | P = 0.004 |
| CGM and pump fills, income ≥US$200,000 subgroup: Black vs WhiteBlack vs White | CGM fills 47.5% vs 43.1% | P = 0.45 |
| CGM and pump fills, income ≥US$200,000 subgroup: Black vs WhiteBlack vs White | pump fills 45.9% vs 38.3% | P = 0.57 |
CGM and pump fills, income ≥US$200,000 subgroup: Black vs White
- Racial difference disappeared with income ≥US$200,000
Original publication
Disparities in technology utilization among youth with type 1 diabetes across diverse racial and socioeconomic backgrounds. BMJ Open Diabetes Res Care. Published 2 May 2025. doi:10.
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