Equitable Post-COVID-19 Care: A Practical Framework to Integrate Health Equity in Diabetes Management

Diabetes Technology Use for Management of Type 1 Diabetes Is Associated With Fewer Adverse COVID-19 Outcomes: Findings From the T1D Exchange COVID-19 Surveillance Registry

“…It remains critical to advocate for equitable access to diabetes technology. In support of this effort, the T1D Exchange Quality Improvement (T1DXQI) Collaborative has proposed a framework to address inequities exacerbated by COVID-19 (5). With this framework, by underscoring structural racism as one of the key drivers of disproportionate technology access, the aim is to identify opportunity gaps where providers can address health inequities with the help of quality improvement principles.…”

Quality Improvement in Diabetes Care: A Review of Initiatives and Outcomes in the T1D Exchange Quality Improvement Collaborative

“…Disparities in any of these areas can lead to inequities in health outcomes. Diabetes outcomes as measured by glycemic control and number of acute complications, use of technology, and access to care are all worse in the Non-Hispanic Black and Hispanic populations ( 48 ). The barriers for these populations may be the result of differences in language or culture, lack of financial resources, or considerable distances to access care ( 49 ).…”

“…To address the literature gap on practical ways health care providers can address inequities in diabetes, the authors proposed a 10-step framework for addressing structural and systemic racism, economic disparities, and education inequities in diabetes care delivery. The framework relies on data to identify SDOH, engage an equitable project team with shared decision-making power, develop policies to expand access to care for the most vulnerable patients, and train clinic staff by naming structural racism as a driver of health inequities ( 48 ). Strategies to incorporate this health equity framework across T1DX-QI member organizations are currently underway.…”

T1D Exchange Quality Improvement Collaborative: A Learning Health System to Improve Outcomes for All People With Type 1 Diabetes

“…Non-Hispanic Black patients with type 1 diabetes who are hospitalized with coronavirus disease 2019 are also more likely to present in DKA ( 2 ). There is a crucial need to address barriers to care and provide resources to overcome unjust and avoidable health disparities that persist within nondominant racial and ethnic groups ( 3 ). Understanding and addressing these barriers can be achieved by understanding our current state and implementing interventions to decrease barriers and improve outcomes.…”

“…In conclusion, we need to work together to use data to drive continuous QI, share best practices, overcome therapeutic inertia, confront racism ( 3 , 32 ), address SDOH, and advocate to accelerate change and address the needs of all people with diabetes. The T1DX-QI learning health system has continued to adapt its infrastructure, research network, and leadership to address inequities in type 1 diabetes care ( 3 ). As the network evolves and grows, it is adjusting its goals to address the latest and most important challenges facing pediatric and adult diabetes clinics.…”