Social Determinants of Health and Continuous Glucose Monitoring Metrics in Type 1 or Type 2 Diabetes
Authors' conclusion
This cross-sectional study of adult and pediatric CGM users with type 1 or type 2 diabetes found that CGM and insulin pump use alone did not eliminate associations between SDOH and glycemic outcomes.
Study context
- Population
- Pediatric (<18 years) and adult (≥18 years) outpatients with T1D or T2D using continuous glucose monitoring (CGM) and meeting CGM data sufficiency criteria, single-centre academic health system, October 1, 2017–February 28, 2025; mean age 38.8 years, 53.1% female3,296 CGM profiles
- Participants
- 1,743 participants
- Exposure
- Race, ethnicity, individual-level social determinants of health (SDOH) (eg, insurance type) and neighborhood-level socioeconomic status
- Outcome
- Glycemic outcomes: HbA1c, mean glucose, TIR, TAR, glycemic risk index, CV and extended hypoglycemic episodes
Methodological detailssingle-centre, inverse probability weighting, mixed-effects models
- Single-centre
- Inverse probability weighting
- Mixed-effects models
Main finding
As reported in the abstract
Associations of SDOH with glycemic metrics
- Black race and public health insurance · Higher hemoglobin A1c (HbA1c)
- estimate 0.55 % (95% CI 0.27%–0.82%)
- Black race and public health insurance · Higher mean glucose
- estimate 17.88 mg/dL (95% CI 3.69-32.07 mg/dL)
- Public insurance · TIR (described as higher TIR)
- estimate −3.56 % (95% CI −5.45% to −1.66%)
- Public insurance · Higher TAR
- estimate 3.49 % (95% CI 1.53%–5.46%)
- Public insurance · Higher glycemic risk index
- estimate 4.50 (95% CI 2.13–6.87)
- Socioeconomic disadvantage · Increase in CV
- estimate 3.26 (95% CI 0.81–5.70)
Observational data: associations, not effects.
Further findings
Subgroups: children
- Associations were most pronounced among children experiencing more socioeconomic disadvantage and Black children across metrics
Original publication
Social Determinants of Health and Continuous Glucose Monitoring Metrics in Type 1 or Type 2 Diabetes. JAMA Netw Open. Published 1 July 2026. doi:10.
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