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Insulin Pump Use in Children with Type 1 Diabetes: Over a Decade of Disparities

Terri H Lipman1, Steven M Willi2, C W Lai3

  • 1Division of Endocrinology and Diabetes, Children's Hospital of Philadelphia, PA, USA; University of Pennsylvania School of Nursing, PA, USA; Perelman School of Medicine, University of Pennsylvania, PA, USA.

Journal of Pediatric Nursing
|September 5, 2020
PubMed

Insights

Racial disparities in insulin pump use among children with type 1 diabetes persist. Non-Hispanic white children are significantly more likely to use insulin pumps than non-Hispanic black children, regardless of socioeconomic status.

Area of Science:

  • Pediatric Endocrinology
  • Health Disparities Research
  • Diabetes Technology Adoption

Background:

  • Racial and ethnic disparities in type 1 diabetes (T1D) outcomes and treatment are well-documented.
  • Insulin pump therapy is a key technology for T1D management, potentially improving glycemic control.
  • Understanding trends in insulin pump use across different racial/ethnic groups is crucial for addressing inequities.

Purpose of the Study:

  • To examine temporal trends in insulin pump utilization among non-Hispanic white (NHW), non-Hispanic black (NHB), and Hispanic children with T1D.
  • To assess the influence of socioeconomic status (SES) on these racial/ethnic disparities in insulin pump use.
  • To investigate potential links between disparities in treatment and T1D outcomes.

Main Methods:

  • Retrospective chart review of T1D patients at a large urban diabetes center.
  • Analysis of insulin pump usage data from 2005 and 2011-2019.
  • Collection of demographic data (age, sex, diabetes duration, SES) and hemoglobin A1c levels for patients from 2011-2019.

Main Results:

  • In 2005, NHW children were twice as likely to use insulin pumps compared to NHB children.
  • From 2011-2019, NHW children remained significantly more likely to use insulin pumps (OR 2.5) than NHB children.
  • Hispanic children also showed higher odds of insulin pump use compared to NHB children, independent of insurance status (a proxy for SES).

Conclusions:

  • Persistent racial disparities in insulin pump use among children with T1D have been observed over 15 years.
  • These disparities are not explained by socioeconomic status, suggesting other contributing factors.
  • Addressing these inequities in treatment is essential to potentially improve glycemic control and reduce complications in NHB children.
Abstract

Keywords:
ChildrenInsulin pumpsRacial disparitiesType 1 diabetes

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