2020
DOI: 10.2337/dci20-0048
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Racial and Socioeconomic Disparities in Pediatric Type 1 Diabetes: Time for a Paradigm Shift in Approach

Abstract: Advancements in diabetes technology have improved quality of life and glycemic control in children with type 1 diabetes. However, a subset of children is being left behind. Those from low-income families and non-Hispanic Black (NHB) children are not experiencing these benefits of technology (1,2) and continue to be at higher risk for complications and adverse outcomes through ongoing poor glycemic control (3). As Addala et al. have demonstrated in a study reported in this issue of Diabetes Care (4), this is a … Show more

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Cited by 71 publications
(66 citation statements)
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“…By contrast, the effect of area deprivation and migration on the use of insulin pump did not change significantly. The decrease of ethnic and socio-economic disparities in CGM use contrasts with the situation observed in other countries with similar rates of CGM-use, like the U.S., 2,4,13,29 and is therefore encouraging. Nevertheless, disparities based on migration background, independent of area deprivation, still impede providing every child an equal access to diabetes technology.…”
Section: Discussionmentioning
confidence: 69%
See 1 more Smart Citation
“…By contrast, the effect of area deprivation and migration on the use of insulin pump did not change significantly. The decrease of ethnic and socio-economic disparities in CGM use contrasts with the situation observed in other countries with similar rates of CGM-use, like the U.S., 2,4,13,29 and is therefore encouraging. Nevertheless, disparities based on migration background, independent of area deprivation, still impede providing every child an equal access to diabetes technology.…”
Section: Discussionmentioning
confidence: 69%
“…28 In the U.S., persistent and strong racial disparities in diabetes technology use, independent of socio-economic status, have been described until recently. 2,13,14,27,29 Overall, complex discriminatory reasons 15,30-32 cannot be excluded. Besides, language barriers certainly limit access of many migrant families to diabetes technology in Germany.…”
Section: Discussionmentioning
confidence: 99%
“…9,10,30,31 The differential use of diabetes technology adoption is considered to be a factor in the inequities seen in HbA1c by SES. 9,32,33 These data call to attention the need for providers to reevaluate their current biases in recommending diabetes technology to youth with T1D. Insurance is inevitably a factor in diabetes technology utilization in the United States, however it should not be one of the most important factors in a provider’s decision to recommend and initiate diabetes technology.…”
Section: Discussionmentioning
confidence: 99%
“…However, there are barriers to technology adoption at the structural, patient, and provider levels ( 12 , 13 ). Structural barriers to CGM adoption include financial challenges related to insurance coverage and associated out-of-pocket costs.…”
mentioning
confidence: 99%