Racial and Ethnic Disparities in Rates of Continuous Glucose Monitor Initiation and Continued Use in Children With Type 1 Diabetes

Lai, Charlene W.; Lipman, Terri H.; Willi, Steven M.; Hawkes, Colin P.

doi:10.2337/dc20-1663

Cited by 84 publications

(60 citation statements)

References 12 publications

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“…19,20 Nonetheless, exclusion of non-CGM users may yield a unique subsample given the recognized disparities in diabetes technology use. [21][22][23] We recognize that our study sample may reflect a more advantaged group of individuals by virtue of their overall use of advanced diabetes technologies and their ability to access telehealth during the pandemic.…”

Section: Discussionmentioning

confidence: 99%

Improvement in Mean CGM Glucose in Young People with Type 1 Diabetes During 1 Year of the COVID-19 Pandemic

Kaushal

Tinsley

Volkening

et al. 2022

Diabetes Technology & Therapeutics

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Section: Discussionmentioning

confidence: 99%

Improvement in Mean CGM Glucose in Young People with Type 1 Diabetes During 1 Year of the COVID-19 Pandemic

Kaushal

Tinsley

Volkening

et al. 2022

Diabetes Technology & Therapeutics

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“…We defined two subgroups, youth (ages 13-18) and young adult (ages [19][20][21][22][23][24] in this cohort study. We calculated the diabetes-related hospitalization rates and evaluated the differences in demographic characteristics between the two groups.…”

Section: Discussionmentioning

confidence: 99%

“…In addition, high prescription drugs costs may reduce insulin adherence and even lead to discontinuation of insulin therapy. An increasing number of studies have shown that use of technology devices, such as pump and CGM, are significantly impacted by the insurance types (19,20).…”

Section: Discussionmentioning

confidence: 99%

Trend of Diabetes-Related Hospital Admissions During the Transition Period From Adolescence to Adulthood in the State of California

Nip

Lodish

2021

Diabetes Care

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OBJECTIVE This study examined the incidence of diabetes-related hospital admissions and described the characteristics among youth and emerging adults with type 1 (T1D) and type 2 diabetes (T2D) in California. RESEARCH DESIGN AND METHODS A retrospective study was conducted using the statewide inpatient database during the years 2014–2018. Individuals aged 13–24 years hospitalized with diabetic ketoacidosis (DKA) or severe hypoglycemia (SH) were recorded. Demographic characteristics and health measures among youth (ages 13–18) and young adults (ages 19–24) were compared. RESULTS A total of 34,749 admission encounters for T1D and 3,304 for T2D were analyzed. Hospitalization rates significantly increased with age during the transition to adulthood, from 70/100,000 California population at age 17 to 132/100,000 at age 19 in T1D. Higher hospitalization rates were demonstrated in young adults than in youth in T1D, and the rate was significantly higher in Black young adults (23.9%) than in youth (12.0%) among the age-adjusted population with diabetes (P < 0.0001). More young adults admitted were on public insurance, and approximately half were from the lowest income quartile. No difference was observed in hospital length of stay; however, hospital charges were higher among young adults. Young adults were three times more likely to be admitted for severe conditions. CONCLUSIONS We demonstrated a significant rise in hospital admission during the transition period in individuals with T1D. There were significantly more Black young adults who were on public insurance and had lower socioeconomic status. Our findings suggest that the health care system fails many emerging adults with diabetes, particularly for people of color, and that improving medical transition is crucial.

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“…Future work should explore the perceptions of male youth, fathers, nontechnology users, and more diverse ethnic samples, as much research shows disparities in technology use for ethnic minorities. [32][33][34] Youth and parents primarily desired an AP system that would reduce physical burdens and mental efforts associated with self-care through a discreet, user-friendly system with personalized algorithms and settings. Stakeholders should be encouraged that young persons with T1D and parents recognize and welcome the potential of AP systems to reduce burden, even without full automation.…”

Section: Many Of the Features Described By Participants Are Currently Avail-mentioning

confidence: 99%

Youth and parent preferences for an ideal AP system: It is all about reducing burden

et al. 2021

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Background As new diabetes technologies improve to better manage glucose levels, users' priorities for future technologies may shift to prioritize burden reduction and ease of use. We used qualitative methods to explore youth and parent desired features of an “ideal” artificial pancreas (AP) system. Methods We conducted semi‐structured interviews with 39 youth, ages 10–25 years, and 44 parents. Interviews were audio‐recorded, transcribed, and coded using thematic analysis. Results Youth (79% female, 82% non‐Hispanic white) were (M ± SD) ages 17.0 ± 4.7 years, with diabetes for 9.4 ± 4.9 years, and HbA1c of 8.4 ± 1.1%; 79% were pump‐treated and 82% used CGM. Of parents, 91% were mothers and 86% were non‐Hispanic white. Participants suggested various ways in which an ideal AP system could reduce physical and emotional burdens of diabetes. Physical burdens could be reduced by lessening user responsibilities to manage glucose for food and exercise, and wear or carry devices. Emotional burden could be reduced by mitigating negative emotional reactions to sound and frequency of alerts, while increasing feelings of normalcy. Youth and parents differed in their suggestions to reduce emotional burden. Participants suggested features that would improve glycemia, but nearly always in the context of how the feature would directly reduce their diabetes‐specific burden. Conclusions Although participants expressed interest in improving glucose levels, the pervasive desire among suggested features of an ideal AP system was to minimize the burden of diabetes. Understanding and addressing users' priorities to reduce physical and emotional burden will be necessary to enhance uptake and maintain use of future AP systems.

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Racial and Ethnic Disparities in Rates of Continuous Glucose Monitor Initiation and Continued Use in Children With Type 1 Diabetes

Cited by 84 publications

References 12 publications

Improvement in Mean CGM Glucose in Young People with Type 1 Diabetes During 1 Year of the COVID-19 Pandemic

Improvement in Mean CGM Glucose in Young People with Type 1 Diabetes During 1 Year of the COVID-19 Pandemic

Trend of Diabetes-Related Hospital Admissions During the Transition Period From Adolescence to Adulthood in the State of California

Youth and parent preferences for an ideal AP system: It is all about reducing burden

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