Equity of Continuous Glucose Monitoring in Children and Young People With Type 1 Diabetes: A Systematic Review
Authors' conclusion
There are significant SES, ethnic and education inequalities in CGM use for CYP with T1D, particularly when reimbursement is limited. This inequity is contributing to inequalities in T1D outcomes. However, evidence suggests CYP benefit equally from CGM use, irrespective of ethnicity and SES.
Study context
- Population
- Children and young people (CYP) with T1D under 26; observational studies published January 2020–July 2023; studies in LMIC, ≤500 participants or only reporting hybrid closed-loop systems excluded27 studies
- Comparison
- Continuous glucose monitoring (CGM) use and HbA1c of CGM users across PROGRESS-Plus criteria
- Outcome
- Proportion of patients using CGM and HbA1c of CGM users
Methodological detailspreregistered protocol, no meta-analysis (heterogeneity), Newcastle-Ottawa Scale quality assessment, 3369 unique studies identified; 27 met inclusion criteria, 33% of studies of 'good' or 'very good' quality
- Preregistered protocol
- No meta-analysis (heterogeneity)
- Newcastle-Ottawa Scale quality assessment
- 3369 unique studies identified; 27 met inclusion criteria
- 33% of studies of 'good' or 'very good' quality
Pooled result
As reported in the abstract
- Decreased CGM use and higher discontinuation for low socioeconomic status (SES), low education, publicly insured and minority ethnic, especially Black, CYP
- Associations generally robust to adjustment for other sociodemographic variables
- Lower SES inequalities in countries where CGM is reimbursed
- For CGM users, no significant association between domains of disadvantage and higher HbA1c, excepting parental education
- Unadjusted ORs calculated from extracted summary data
Original publication
Equity of Continuous Glucose Monitoring in Children and Young People With Type 1 Diabetes: A Systematic Review. Pediatr Diabetes. Published 3 June 2025. doi:10.
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