Introduction: The multi-center T1D Exchange QI Collaborative (T1DX-QI) is a learning health network sharing de-identified electronic medical record data for type 1 diabetes (T1D) care improvement.

Objectives: To investigate trends in racial and ethnic inequities in glycemic outcomes in children and adults with T1D from 2016 to 2021.

Methods: Children and adults with T1D for at least 6 months in participating T1DX-QI centers with data available from 2016 to 2021 were included. Temporal trends by race and ethnicity in HbA1c were analyzed using regression models. Age, gender, duration of diabetes, insurance type, were adjusted as covariates.

Results: Figure 1, among 36,390 children and adults with T1D, HbA1c outcomes for Non-Hispanic White (NHW) patients decreased from 8.5% in 2016 to 8.2% in 2021 (p-0.001) , remained stable across the six years for Hispanic patients (8.9%) and Asian (8.4%) but increased for Non-Hispanic Black (NHB) from 9.6% in 2016 to 9.9% in 2021 (p-0.001) . The use of Insulin Pumps and CGM increased significantly among all groups.

Conclusions: Six years of longitudinal follow-up revealed lower HbA1c over time in NHW patients but higher HbA1c for NHB patients despite adjusting for multiple confounders. It is critical to address the root causes of inequities in NHB and patients of other racial minorities with T1D.


O.Ebekozien: None. A.Albanese-o'neill: Consultant; Association of Diabetes Care & Education Specialists, Provention Bio, Inc., Other Relationship; Insulet Corporation, Tandem Diabetes Care, Inc. D.M.Maahs: Advisory Panel; Abbott Diabetes, Eli Lilly and Company, Medtronic, Novo Nordisk, Sanofi, Consultant; Aditx Therapeutics, Inc., Biospex. M.A.Clements: Consultant; Glooko, Inc., Research Support; Abbott Diabetes, Dexcom, Inc. T1dx-qi collaborative: n/a. N.Noor: None. M.K.Kamboj: None. O.Odugbesan: n/a. S.Majidi: None. R.Hopkins: None. E.L.Dewit: None. R.Izquierdo: None. S.Agarwal: Advisory Panel; Medtronic, Consultant; Beta Bionics, Inc.


Helmsley Charitable Trust

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