Introduction: Socioeconomic status (SES) is associated with health disparities in youth with T1D. We aimed to evaluate SES and glycemic metrics in youth with T1D using continuous glucose monitors (CGM).

Methods: This IRB approved study included demographics, insulin administration type (pump/injections), and glycemic data from HbA1c and corresponding 14 day (d) and 90 d CGM metrics. Analysis was performed in MiniTab®.

Results: A total of 205 patients, 161 Non-Hispanic White (NHW) and 44 Non-Hispanic Black (NHB), were included. A minority (n=45, 22.0%) were publicly insured. Half (49.7%) used an insulin pump. There was no significant difference between sex, age, age at diagnosis, diabetes duration, or pump use between NHB and NHW patients. A higher proportion of NHB patients were on public insurance (45.5 vs 15.5%, p<0.0001). No difference in pump use was seen based upon insurance. Glycemic metrics for NHW and NHB patients differed including: HbA1c (median (med) 7.6 vs 9.2, p<0.001), 14 d mean glucose (mg/dL) (189.6 vs 207.4, p=0.038), 14 d standard deviation (SD) (67.2 vs 77.7, p=0.006), 14 d time in range (TIR) (51.8 vs 42.0%, p=0.016), 14 d time < 250 (med 52.9 vs 37.3%, p=0.005), 90 d mean glucose (181.0 vs 220.0, p<0.001), 90 d SD (69.5 vs 79.4, p=0.006), 90 d TIR (50.7 vs 37.9%, p=0.001) and 90 d time < 250 (med 16.4 vs 34.7%, p<0.001). Similar differences were seen between public and privately insured patients including: HbA1c (med 8.7 vs 7.6%, p=0.003), 14 d mean glucose (214.0 vs 183.5, p=0.019), 14 d TIR (43.2 vs 51.7%, p=0.034), 14 d time < 250 (med 30.6 vs 17.9%, p=0.031), 90 d mean glucose (219.5 vs 181.0, p<0.0001), 90 d SD (77.6 vs 70.0, p=0.023), 90 d TIR (39.1 vs 50.4%, p=0.004) and 90 d time < 250 (med 35.4 vs 16.3%, p<0.0001).

Discussion: Disparities in glycemic control were seen in NHB and publicly insured patients despite CGM use and a high and equitable use of insulin pumps. While access to technology for diabetes is important, in this cohort it was not adequate to reduce disparities in glycemic outcomes based on SES.

Disclosure

M.C.Nath: None. J.Atchison: None. J.Schmitt: None.

© 2023 by the American Diabetes Association
2023
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