Timing of insulin pump initiation among individuals with type 1 diabetes in Ontario, Canada
Authors' conclusion
Social disadvantage and physician characteristics are associated with less earlier pump initiation, which may have negative long-term effects on glycaemic management. Barriers to earlier pump initiation should be removed to promote equitable access and optimize glycaemic outcomes.
Study context
- Population
- New T1D applicants to the publicly funded insulin pump program in Ontario, Canada, prior to 31 March 2021
- Participants
- 4,899 participants
- Exposure
- Earlier vs later insulin pump initiation
- Outcome
- Characteristics associated with earlier vs later pump initiation; cumulative glycaemic exposure (cumulative HbA1c)
Methodological detailsadministrative healthcare databases
- Administrative healthcare databases
Main finding
As reported in the abstract
Estimate (95% CI)
Most disadvantaged quintilevs Least disadvantaged quintilelikelihood of earlier pump initiation
adjusted RR 0.81(0.75–0.88)
Endocrinologistvs Paediatricianearlier pump initiation
RR 0.85(0.79–0.91)
General internistvs Paediatricianearlier pump initiation
RR 0.73(0.64–0.83)
Family physicianvs Paediatricianearlier pump initiation
RR 0.28(0.21–0.37)
- Earlier pump initiators
- 62.6%
Observational data: associations, not effects.
Further findings
| Outcome | Difference (% per year) (95% CI) | P value | |
|---|---|---|---|
| Annual rate of increase in cumulative HbA1c | −0.33 (−0.45 to −0.20) | P < 0.001 | |
| −0.6−0.4−0.200.2Difference, % per year (linear scale) |
| Outcome | Mean difference | P value |
|---|---|---|
| Cumulative HbA1c · 10 yearsDid not differ significantly | −1.50 | P = 0.112 |
Original publication
Timing of insulin pump initiation among individuals with type 1 diabetes in Ontario, Canada. Diabetes Obes Metab. Published 26 January 2026. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →