Addressing disparities in technology use among patients with type 1 diabetes: a review

Curr Opin Endocrinol Diabetes Obes. 2024 Feb 1;31(1):14-21. doi: 10.1097/MED.0000000000000840. Epub 2023 Oct 25.

Abstract

Purpose of review: The benefits of continuous glucose monitors (CGMs) and insulin pumps in the management of type 1 diabetes (T1D) are widely recognized. However, glaring disparities in access exist, particularly in marginalized and economically disadvantaged groups that stand to benefit significantly from diabetes technology use. We will review recent data describing drivers of these disparities and approaches to address the disparities.

Recent findings: Several qualitative studies were published in recent years that have investigated the drivers of disparities reported over the past decades. These studies report that in addition to typical barriers seen in the diabetes technology, marginalized patients have unique challenges that make insulin pumps and CGMs less accessible.

Summary: Barriers to technology use in these groups include stigmatization, lack of support, financial constraints, provider biases, stringent insurance policies, and clinic infrastructure. To address inequities, multifaceted strategies across community, healthcare, and provider sectors are essential. Key initiatives include enhancing public awareness, refining health policies, ensuring access to high-quality care, and emphasizing patient-centered approaches. The equitable use of technology can narrow the gap in T1D outcomes. The social and economic implications of suboptimal T1D management further underscore the urgency of these efforts for both improved health outcomes and cost-efficient care.

Publication types

  • Review
  • Research Support, N.I.H., Extramural

MeSH terms

  • Blood Glucose
  • Diabetes Mellitus, Type 1* / drug therapy
  • Health Policy
  • Humans
  • Insulins*
  • Quality of Health Care

Substances

  • Blood Glucose
  • Insulins