Social Determinant of Health Impact on Diabetes Device Use and Clinical Outcomes in Youth with Type 1 Diabetes
Authors' conclusion
Interventions that tailor care plans to address SDoH in families living in deprived neighborhoods may be needed to increase successful technology uptake, optimize HbA1c, and prevent DKA.
Study context
- Population
- Youth with T1D seen Oct 1, 2020–Sep 30, 2021 at a large pediatric diabetes center (50% female, age 12.8 ± 3.6 years, hemoglobin A1c (HbA1c) 8.7 ± 2.1%, 52% pump, 70% CGM)
- Participants
- 1,461 participants
- Exposure
- Area deprivation index (ADI) and other social determinants of health (SDoH) factors in relation to pump/CGM use, HbA1c and diabetic ketoacidosis (DKA)
- Outcome
- Associations of ADI and other SDoH with device use, HbA1c and DKA
Methodological detailssingle-centre, multiple logistic and linear regression adjusted for potential confounders
- Single-centre
- Multiple logistic and linear regression adjusted for potential confounders
Main finding
As reported in the abstract
HbA1c (%) increase per unit increase in ADI
0.09
95% CI 0.05, 0.13
Observational data: associations, not effects.
Further findings
| Outcome | Difference (95% CI) |
|---|---|
| HbA1c by device useBetween Pump users and Nonusers | 0.62 (−0.82 to −0.42) |
| HbA1c by device useBetween CGM users and Nonusers | 0.78 (−0.99 to −0.56) |
HbA1c by device use
- HbA1c lower in pump users vs nonusers and in CGM users vs nonusers
Original publication
Social Determinant of Health Impact on Diabetes Device Use and Clinical Outcomes in Youth with Type 1 Diabetes. Pediatr Diabetes. Published 30 October 2023. doi:10.
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