M Rebecca O'Connor1, Kristen Carlin2, Tumaini Coker3, Brenda Zierler4, Catherine Pihoker2. 1. School of Nursing, University of Washington, Seattle, USA. Electronic address: rebeccao@uw.edu. 2. Seattle Children's Research Institute, USA. 3. School of Medicine, University of Washington, Seattle, USA. 4. School of Nursing, University of Washington, Seattle, USA.
Abstract
PURPOSE: This study sought to determine if disparities in insulin pump therapy among youth with type 1 diabetes (T1DM) persist despite recent increases in overall pump use rates. DESIGN AND METHODS: All patients aged 6 months-17 years, diagnosed with T1DM, and completed 4+ outpatient diabetes visits at an academically-affiliated pediatric health care center from 2011 to 2016 were identified (n = 2131). Data were collected from existing electronic medical records and a multivariable logistic regression model was used to identify factors associated with insulin pump therapy. RESULTS: Findings revealed one novel factor (patients/families whose primary language is Spanish [OR 0.47, p = 0.038] or other non-English languages [OR 0.47, p = 0.028]) and confirmed several previously known factors associated with lower insulin pump use: patients who were older (10-14 years OR 0.38, p < 0.0001; 15+ years OR 0.15, p < 0.0001), male (OR 0.80, p = 0.021), non-Hispanic black (OR 0.59, p = 0.009), American Indian/Alaska Native (OR 0.19, p = 0.023), had either government (OR 0.42, p < 0.0001) or no insurance (OR 0.52, p = 0.004) and poor glycemic control (at least one HbA1c ≥ 8.5%; OR 0.54, p < 0.0001). CONCLUSION: Significant disparities in insulin pump use in youth with T1DM persist despite known benefits associated with pump therapy and underlying causes remain unclear. PRACTICE IMPLICATIONS: Health care providers should explore barriers to insulin pump therapy, including limited English language proficiency.
PURPOSE: This study sought to determine if disparities in insulin pump therapy among youth with type 1 diabetes (T1DM) persist despite recent increases in overall pump use rates. DESIGN AND METHODS: All patients aged 6 months-17 years, diagnosed with T1DM, and completed 4+ outpatientdiabetes visits at an academically-affiliated pediatric health care center from 2011 to 2016 were identified (n = 2131). Data were collected from existing electronic medical records and a multivariable logistic regression model was used to identify factors associated with insulin pump therapy. RESULTS: Findings revealed one novel factor (patients/families whose primary language is Spanish [OR 0.47, p = 0.038] or other non-English languages [OR 0.47, p = 0.028]) and confirmed several previously known factors associated with lower insulin pump use: patients who were older (10-14 years OR 0.38, p < 0.0001; 15+ years OR 0.15, p < 0.0001), male (OR 0.80, p = 0.021), non-Hispanic black (OR 0.59, p = 0.009), American Indian/Alaska Native (OR 0.19, p = 0.023), had either government (OR 0.42, p < 0.0001) or no insurance (OR 0.52, p = 0.004) and poor glycemic control (at least one HbA1c ≥ 8.5%; OR 0.54, p < 0.0001). CONCLUSION: Significant disparities in insulin pump use in youth with T1DM persist despite known benefits associated with pump therapy and underlying causes remain unclear. PRACTICE IMPLICATIONS: Health care providers should explore barriers to insulin pump therapy, including limited English language proficiency.
Authors: Karina Javalkar; Victoria K Robson; Lukas Gaffney; Amy M Bohling; Puneeta Arya; Sarah Servattalab; Jordan E Roberts; Jeffrey I Campbell; Sepehr Sekhavat; Jane W Newburger; Sarah D de Ferranti; Annette L Baker; Pui Y Lee; Megan Day-Lewis; Emily Bucholz; Ryan Kobayashi; Mary Beth Son; Lauren A Henderson; John N Kheir; Kevin G Friedman; Audrey Dionne Journal: Pediatrics Date: 2021-02-18 Impact factor: 7.124
Authors: Jennifer L Sherr; Anke Schwandt; Helen Phelan; Mark A Clements; Reinhard W Holl; Paul Z Benitez-Aguirre; Kellee M Miller; Joachim Woelfle; Thomas Dover; David M Maahs; Elke Fröhlich-Reiterer; Maria E Craig Journal: Pediatrics Date: 2021-08 Impact factor: 9.703