Impact of social disadvantage on clinical and health care use indicators in adults with type 1 diabetes using insulin pumps in Ontario, Canada
Authors' conclusion
Social disadvantage was associated with worse clinical outcomes but not health care use indicators among pump users with T1D in Ontario. Social disadvantage remains a risk factor for poorer clinical outcomes among pump users, but pump use may sustain greater engagement with the diabetes care team.
Study context
- Population
- Adults with T1D who initiated insulin pump therapy between 1 April 2012 and 30 March 2020, Ontario, Canada; 14% from the most socially disadvantaged quintile
- Participants
- 15,755 adults
- Exposure
- Most vs least socially disadvantaged quintile
- Outcome
- HbA1c and hospitalization/ED visits for hyperglycaemia and hypoglycaemia
Methodological detailsadministrative health data, multivariable Poisson and linear regression, generalized estimating equations (GEE) models accounting for clustering by region
- Administrative health data
- Multivariable Poisson and linear regression
- GEE models accounting for clustering by region
Main finding
As reported in the abstract
Most disadvantaged quintile vs Least disadvantaged quintileDifference in HbA1c, % (95% CI)
Higher HbA1c with greater disadvantage
0.12(0.06–0.17)
Most disadvantaged quintile vs Least disadvantaged quintileEstimate (95% CI)
HbA1c and hospitalization/ED visits for hyperglycaemia and hypoglycaemia
aRR, hospitalization/ED visits for hyperglycaemia 2.07(1.64–2.62)
HbA1c and hospitalization/ED visits for hyperglycaemia and hypoglycaemia
aRR, hospitalization/ED visits for hypoglycaemia 1.76(1.41–2.19)
Observational data: associations, not effects.
Further findings
Health care use indicators (HbA1c tests and endocrinologist outpatient visits per year)
- No associations between social disadvantage and health care use indicators
Original publication
Impact of social disadvantage on clinical and health care use indicators in adults with type 1 diabetes using insulin pumps in Ontario, Canada. Diabetes Obes Metab. Published 24 June 2025. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →