Disparities in Insulin Pump Therapy Persist in Youth With Type 1 Diabetes Despite Rising Overall Pump Use Rates.
M Rebecca O'Connor, Kristen Carlin, Tumaini Coker and 2 others
PMID 30581163WHAT IT FOUND
Youth with type 1 diabetes who speak Spanish or other non-English languages, have government insurance, or are older are significantly less likely to receive insulin pump therapy.
Disparities persist despite rising overall pump use rates.
Key findings
01Patients whose primary language was Spanish or other non-English were about half as likely to use an insulin pump compared to English-speaking patients.
02Patients with government or no insurance were about half as likely to use an insulin pump compared to those with commercial insurance.
03Older patients and male patients were significantly less likely to use an insulin pump.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study used retrospective data, so it could not determine if patients were offered pump therapy but declined it for personal or logistical reasons. Insurance type was used as a proxy for household income, which may not accurately capture socioeconomic status. Patients with missing data were excluded, which could bias results. Small sample sizes for some racial/ethnic groups (e.g., American Indian/Alaska Native) limit the certainty of findings for those groups.
Declared interests
The authors have no conflicts of interest.
The easy way to misread this
Do not assume that lower pump use in specific demographic groups is solely due to patient preference or lack of access. The study used pump orders as a proxy and could not measure if providers were less likely to offer pumps to these groups, meaning implicit bias or provider factors may play a role.