Objective: Recent research highlighted racial and ethnic inequities in the use of diabetes technology among Medicare Fee-For-Service beneficiaries with type 1 diabetes. This study considers inequities among Medicare Advantage beneficiaries.

Methods: We assessed use of continuous glucose monitoring (CGM) and insulin pump technologies among beneficiaries with type 1 diabetes using a national database of health care claims between 2018 and 2020. The prevalence of CGM, pump, and combined technology was assessed annually (N = 17231 in 2018; N = 16298 in 2019; N = 15877 in 2020) by race and ethnicity. Within each year and type of technology, chi-square tests assessed differences in use between racial and ethnic groups.

Results: Prevalence of diabetes technology increased within each racial and ethnic group over the study period. There were significant differences in technology use between groups by year (p < 0.001) . In 2020, 37.1% of White beneficiaries used CGM devices, compared to 27.8% of Asian, 25.8% of Black, and 21.0% of Hispanic beneficiaries. The absolute difference in CGM use between White beneficiaries and those in other groups was stable or increased from 2018 to 2020. Similar trends were observed in pump use alone or with CGM.

Conclusion: While prevalence of diabetes technology increased across all racial and ethnic groups from 2018 to 2020, racial and ethnic inequities have persisted.


M.Kommareddi: Employee; Medtronic. K.Wherry: Employee; Medtronic. R.A.Vigersky: Employee; Medtronic.

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