The Insulin-Only Bionic Pancreas Improves Glycemic Control in Non-Hispanic White and Minority Adults and Children with Type 1 Diabetes

Abstract

<p> </p> <p><strong>Objective: </strong>We evaluated the performance of the iLet® bionic pancreas (BP) in non-Hispanic Whites (‘Whites’) and in Blacks, Hispanics, and others (‘Minorities’).</p> <p><strong>Research Design and Methods:</strong> A multicenter, randomized controlled trial evaluated glycemic management with the BP versus standard-of-care (SC) in 161 adult and 165 pediatric participants with type 1 diabetes over 13 weeks. </p> <p><strong>Results:</strong> In Whites (N=240), the mean baseline-adjusted difference in 13-week HbA1c between the BP and SC groups was -0.45% (95% CI -0.61% to -0.29% [-4.9, -6.6 to -3.1 mmol/mol]; P<0.001), while this difference among Minorities (N=84) was -0.53% (-0.83% to -0.24% [-6.0, -9.2 to -2.8 mmol/mol]; P<0.001). In Whites, the mean baseline-adjusted difference in TIR between the BP and SC groups was 10% (7 to 12%; P<0.001), while in Minorities it was 14% (10 to 18%; P<0.001). </p> <p><strong>Conclusions:</strong> The BP improves glycemic control in both Whites and Minorities and offers promise in decreasing health care disparities. </p>

Making a Good Thing Even Better: Expanding Access and Applicability of Automated Insulin Delivery Systems to Benefit All Youth With Type 1 Diabetes

“…The idea that efficacious technology must be proven in less resourced groups has resulted in delayed adoption of equitable policies. Technology works effectively in minoritized populations (5,7,17)-it is more important that minoritized individuals are supported to minimize the impact of structural inequities (3). In this meta-analysis, the role of study supervision was critical to the optimization of AID.…”