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Title: Racial-ethnic disparities in diabetes technology use among young adults with type 1 diabetes.
Authors: Gonzalez, Jeffrey S.
Agarwal, Shivani
Schechter, Clyde
Long, Judith A.
Keywords: continuous glucose monitor (CGM)
racial–ethnic disparities
insulin pump
type 1 diabetes (T1D)
socioeconomic status (SES).
young adults (YA)
non-Hispanic (NH)
Self-Care Inventory score
Issue Date: 2021
Publisher: Mary Ann Liebert Incorporated
Citation: Agarwal, S., Schechter, C., Gonzalez, J., & Long, J. A. (2021). Racial-ethnic disparities in diabetes technology use among young adults with type 1 diabetes. Diabetes Technology & Therapeutics, 23(4), 306–313.
Series/Report no.: Diabetes Technology & Therapeutics;23(4)
Abstract: _Background:_ Recent studies highlight racial–ethnic disparities in insulin pump and continuous glucose monitor (CGM) use in people with type 1 diabetes (T1D), but drivers of disparities remain poorly understood beyond socioeconomic status (SES). _Methods:_ We recruited a diverse sample of young adults (YA) with T1D from six diabetes centers across the United States, enrolling equal numbers of non-Hispanic (NH) White, NH Black, and Hispanic YA. We used multivariate logistic regression to examine to what extent SES, demographics, health care factors (care setting, clinic attendance), and diabetes self-management (diabetes numeracy, self-monitoring of blood glucose, and Self-Care Inventory score) explained insulin pump and CGM use in each racial–ethnic group. _Results:_ We recruited 300 YA with T1D, aged 18–28 years. Fifty-two percent were publicly insured, and the mean hemoglobin A1c was 9.5%. Large racial–ethnic disparities in insulin pump and CGM use existed: 72% and 71% for NH White, 40% and 37% for Hispanic, and 18% and 28% for NH Black, respectively. After multiple adjustment, insulin pump and CGM use remained disparate: 61% and 53% for NH White, 49% and 58% for Hispanic, and 20 and 31% for NH Black, respectively. _Conclusions:_ Insulin pump and CGM use was the lowest in NH Black, intermediate in Hispanic, and highest in NH White YA with T1D. SES was not the sole driver of disparities nor did additional demographic, health care, or diabetes-specific factors fully explain disparities, especially between NH Black and White YA. Future work should examine how minority YA preferences, provider implicit bias, systemic racism, and mistrust of medical systems help to explain disparities in diabetes technology use.
Description: Scholarly article
ISSN: ISSN: 1520-9156, 1557-8593
Appears in Collections:Ferkauf Graduate School of Psychology: Faculty Publications

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