Trends and Disparities in Technology Use and Glycemic Control in Type 1 Diabetes
Authors' conclusion
In this cross-sectional study, there was a rapid increase in the use of diabetes technology and notable improvements in glycemic control among youths and adults with T1D during the past 15 years. Nonetheless, the prevalence of glycemic control remained low, and racial, ethnic, and socioeconomic differences grew over time.
Study context
- Population
- US youths and adults with T1D in a national deidentified EHR database, January 1, 2009, to December 31, 2023; mean age 40 years, 52% male
- Participants
- 186,590 participants
- Exposure
- 3-year study periods, 2009-2011 to 2021-2023
- Youthsn = 26,853
- Adultsn = 159,737
- Outcome
- Glycemic control (mean HbA1c <7%) and use of diabetes technology (CGM and/or insulin pumps)
- Follow-up
- 3-year study periods 2009-2011 to 2021-2023
Methodological detailsnational EHR database (Optum Labs Data Warehouse)
- National EHR database (Optum Labs Data Warehouse)
Main finding
As reported in the abstract
Prevalence of glycemic control (mean HbA1c <7%) · 2009-2011 to 2021-2023
- Youths: increased from 7% (95% CI, 7%-8%) to 19% (95% CI, 19%-20%)
- P < .001 for trend
- Adults: increased from 21% (95% CI, 21%-22%) to 28% (95% CI, 28%-29%)
- P < .001 for trend
Observational data: associations, not effects.
Further findings
Use of diabetes technology · 2009-2011 to 2021-2023
- CGM use, youths
- 4% to 82%
- CGM use, adults
- 5% to 57%
- Insulin pump use, youths
- 16% to 50%
- Insulin pump use, adults
- 11% to 29%
- Both devices concurrently, youths
- 1% to 47%
- Both devices concurrently, adults
- 1% to 22%
- P < .001 for trend for all
Disparities
- Glycemic control and technology use lowest in Hispanic, non-Hispanic Black and Medicaid-insured youths and adults; differences persisted or increased over time
Original publication
Trends and Disparities in Technology Use and Glycemic Control in Type 1 Diabetes. JAMA Netw Open. Published 1 August 2025. doi:10.
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