Background: Inequities among technology use in pediatric type 1 diabetes (T1D) patients remains prevalent. These disparities contribute to poor glycemic control.
Method: This study was a retrospective chart review of HbA1C and CGM use by type of insurance, ethnicity and language spoken at home in 2022.
Results: In a cohort of nearly 2000 T1D pediatric patients, differences were found in HbA1c levels between ethnicities (mean of 8.6% Hispanics and 8.1% non-Hispanics). However, when stratified by insurance type (Private vs Medicaid), the relationship of ethnicity to HbA1C levels was no longer present, suggesting insurance drives differences in HbA1C levels rather than ethnicity. The effects of insurance may in part be related to technology use. An average of 45% of patients with private insurance use CGMs, in comparison with 32% of those with Medicaid. The use of CGMs compared with non-use of CGMs had a positive effect on HbA1C (8.3% vs 9.0%).
Conclusions: CGM use is associated with lower HbA1C levels in our practice. Patients on Medicaid had higher HbA1C levels and less use of CGM. Hispanic and non-English speaking patients were more likely to be on Medicaid, and to have higher HbA1C levels and lower use of CGMs. These findings highlight the need to reduce health inequities among these populations. Our clinic will aim to develop interventions to improve technology use and access in Medicaid, Hispanic, and non-English speaking populations.
L.Holzmeister: None. S.Chmelnik: None.
