Barriers and promoters to CGM and AID use in youth with T1D and public insurance
Photo by Faustina Okeke / Unsplash
Key Takeaway
Note that interventions effective in increasing diabetes technology uptake in youth with T1D and public insurance are necessary to mitigate disparities.
This prospective, mixed-methods study focused on youth with type 1 diabetes (T1D) who have public insurance. The investigation assessed barriers and promoters to the use of continuous glucose monitoring (CGM) and artificial insulin delivery (AID). The primary outcome measured was diabetes technology acceptance. No specific sample size, setting, or follow-up duration were reported in the available data.
The study did not report specific numerical results for technology acceptance rates, nor did it provide data on adverse events, serious adverse events, discontinuations, or general tolerability. Consequently, no specific percentages or p-values can be cited regarding the main findings or safety profile.
Key limitations include the lack of reported sample size, setting details, and follow-up duration. The study did not report funding sources or conflicts of interest. Causality was not reported, and the evidence certainty was not explicitly defined.
Practice relevance suggests that interventions effective in increasing the uptake and continued use of diabetes technology in youth with T1D and public insurance are necessary to mitigate disparities. Clinicians should recognize the need for such interventions without overstating the specific efficacy data provided by this study.
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View Original Abstract ↓
Continuous glucose monitoring (CGM) and automated insulin delivery (AID) systems have led to improved outcomes in type 1 diabetes (T1D). Diabetes technology use in minoritized populations is 50% lower than more privileged groups. Tailored, multi-factorial interventions are needed to address disparities and improve technology uptake in minoritized youth with T1D. The Building the Evidence to Address Disparities in Type 1 Diabetes (BEAD-T1D) Study assesses drivers of disparities in CGM and AID use in youth with T1D and public insurance to develop an intervention to increase uptake of diabetes technology. This manuscript describes the rationale, design, and protocols of the study. BEAD-T1D is a prospective, mixed-methods study grounded in the social-ecological model informed by sequential triangulation. Study Aim 1 constructs an evidence base of barriers and promoters to CGM and AID use in youth with T1D and public insurance to formulate and test a pilot intervention to increase device uptake in minoritized populations. Study Aim 2 constructs an evidence base of barriers and promoters to recommending devices to youth with T1D and public insurance to formulate and test a pilot intervention for healthcare providers to increase recommendations of devices. The primary outcome is diabetes technology acceptance analyzed via descriptive statistics and univariate analyses to inform the systematic building of a multivariable model. BEAD-T1D lays the groundwork for future efforts to reduce disparities in the uptake and continued use of diabetes technology in marginalized populations. Interventions effective in increasing the uptake and continued use of diabetes technology in youth with T1D and public insurance are necessary to mitigate disparities.
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