Type 1 Diabetes: Racial, Socioeconomic Disparities in Insulin Pump Use

Racial disparities: Lower odds ratios were seen for insulin pump use for Hispanic, Black, and other race versus White; with lower education, lower household income

Racial, ethnic, and socioeconomic disparities in insulin pump use have persisted during the past two decades, according to a study published online in Diabetes Technology & Therapeutics.

Estelle M. Everett, M.D., from the David Geffen School of Medicine at the University of California in Los Angeles, and colleagues conducted a serial cross-sectional analysis to examine changes in insulin pump use among participants aged younger than 20 years with type 1 diabetes by race/ethnicity and markers of socioeconomic status across four periods between 2001 and 2019.

The researchers observed an increase in insulin pump use from 31.7 to 58.8 percent, but disparities in pump use persisted over time and were unchanged across subgroups. Compared with White participants, Hispanic, Black, and other race participants had significantly lower odds ratios for insulin pump use (odds ratios, 0.57, 0.28, and 0.49, respectively).

Compared with those with at least a bachelor’s degree, those with no more than a high school degree and some colleges had lower use (odds ratios, 0.39 and 0.68, respectively).

Compared with those with private insurance, those with public insurance also had lower use (odds ratio, 0.84). In addition, compared with those with an annual household income ≥$75,000, lower use was seen for those with an annual household income of <$25,000, $25,000 to $49,000, and $50,000 to $74,000 (odds ratios, 0.43, 0.52, and 0.79, respectively).

“This is very concerning because these groups have more challenges managing their diabetes and have a higher risk of complications with diabetes, so they may actually gain the most benefit from diabetes technology use,” Everett said in a statement.

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