Enhancing equity in access to automated insulin delivery systems in an ethnically and socioeconomically diverse group of children with type 1 diabetes
Authors' conclusion
A flexible virtual flipped learning programme increases onboarding cadence and capacity to offer equitable AID system onboarding.
Study context
- Population
- Children and young people (CYP) with T1D using continuous glucose monitoring (CGM), initiated on automated insulin delivery (AID) systems between 2021 and 2023
- Participants
- 74 vs 91
- Exposure
- In-person manufacturer-supported didactic teaching (Group A) vs flexible flipped learning, virtual or in-person (Group B) for AID onboarding
- Group An = 74reference
- Group Bn = 91
- Outcome
- CGM metrics (TAR, TIR, TBR) from baseline to 90 days
- Follow-up
- 90 days
Main finding
As reported in the abstract
Change in CGM metrics (∆ TAR, TIR, TBR) between groups · baseline to 90 days
- ∆ time above range (TAR), time in range (TIR) and time below range (TBR) for both groups were comparable
- No difference from baseline to 90 days for TBR in Group A and Group B
Observational data: associations, not effects.
Further findings
- Virtual flipped learning uptake and onboarding — Group B
- 87%
- TAR (>10.0 mmol/L), baseline to 90 days, Group A
- 47.6% to 33.2% · mean · SD ±15.0 to ±15.0
- TIR (3.9-10.0 mmol/L), baseline to 90 days, Group A
- 50.4% to 64.7% · mean · SD ±14.0 to ±10.2
- TAR, baseline to 90 days, Group B
- 51.3% to 34.5% · SD ±15.1 to ±11.3
- TIR, baseline to 90 days, Group B
- 46.5% to 63.7% · SD ±14.5 to ±11.0
- TAR (>10.0 mmol/L), baseline to 90 days, Group A: p<0.001
- TIR (3.9-10.0 mmol/L), baseline to 90 days, Group A: p<0.001
- TAR, baseline to 90 days, Group B: p<0.001
- TIR, baseline to 90 days, Group B: p<0.001
Demographics
- Group B had higher socioeconomic deprivation, greater ethnic diversity and lower carer education achievement
- P < 0.05
Virtual flipped learning uptake and onboarding
- Virtual flipped learning halved diabetes educator time and increased onboarding cadence fivefold
Original publication
Enhancing equity in access to automated insulin delivery systems in an ethnically and socioeconomically diverse group of children with type 1 diabetes. BMJ Open Diabetes Res Care. Published 15 May 2024. doi:10.
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