Racial-ethnic disparities in diabetes technology use among young adults with type 1 diabetes.

dc.contributor.authorGonzalez, Jeffrey S.
dc.contributor.authorAgarwal, Shivani
dc.contributor.authorSchechter, Clyde
dc.contributor.authorLong, Judith A.
dc.date.accessioned2023-10-24T16:39:35Z
dc.date.available2023-10-24T16:39:35Z
dc.date.issued2021
dc.descriptionScholarly articleen_US
dc.description.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.en_US
dc.identifier.citationAgarwal, 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. https://doi.org/10.1089/dia.2020.0338en_US
dc.identifier.doihttps://doi.org/10.1089/dia.2020.0338en_US
dc.identifier.issnISSN: 1520-9156, 1557-8593
dc.identifier.urihttps://www.liebertpub.com/doi/10.1089/dia.2020.0338en_US
dc.identifier.urihttps://hdl.handle.net/20.500.12202/9357
dc.language.isoen_USen_US
dc.publisherMary Ann Liebert Incorporateden_US
dc.relation.ispartofseriesDiabetes Technology & Therapeutics;23(4)
dc.rightsAttribution-NonCommercial-NoDerivs 3.0 United States*
dc.rights.urihttp://creativecommons.org/licenses/by-nc-nd/3.0/us/*
dc.subjectcontinuous glucose monitor (CGM)en_US
dc.subjectracial–ethnic disparitiesen_US
dc.subjectinsulin pumpen_US
dc.subjecttype 1 diabetes (T1D)en_US
dc.subjectsocioeconomic status (SES).en_US
dc.subjectyoung adults (YA)en_US
dc.subjectnon-Hispanic (NH)en_US
dc.subjectSelf-Care Inventory scoreen_US
dc.titleRacial-ethnic disparities in diabetes technology use among young adults with type 1 diabetes.en_US
dc.typeArticleen_US
local.yu.facultypagehttps://www.yu.edu/faculty/pages/gonzalez-jeffreyen_US

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