Lower Diabetes Technology Adoption and Worse Glycemic Control in Minorities with Type 1 Diabetes

Introduction: Poorer outcomes in acute and late complications of type 1 diabetes (T1D) persist among racial/ethnic minorities, and technology adoption may be lower in these groups. Technologies such as continuous glucose monitors (CGM) and insulin pumps (CSII) enhance diabetes management and improve glycemic control. We examined differences in use of diabetes technology by race/ethnicity among patients 12 and older followed at the Barbara Davis Center who had T1D for at least 1 year. Methods: Use of CGM and/or CSII vs. neither was examined in 5,539 patients by racial/ethnic groups: Non-Hispanic White (NHW, n=3,945) , Black (n=161) , Hispanic (n=719) and Other racial groups (OR, n=714) . General liner models compared HbA1c and technology use by race/ethnicity. Results: Black, Hispanic and OR patients were younger, had shorter T1D duration, higher HbA1c and less use of technology. In linear models adjusted for age, diabetes duration and visits over the past year, use of technology was associated with lower HbA1c in each race/ethnic group. However, among technology users, minority patients had higher HbA1c compared to NHW patients. Conclusion: HbA1c was highest and diabetes technology use lowest among Blacks and Hispanics. Efforts to increase technology use for diabetes management in these populations may result in greater glycemic control and ultimately the reduction of acute and late complications of diabetes. Disclosure B.Conway: None. V.Shah: Advisory Panel; Medscape, Sanofi, Consultant; Dexcom, Inc., Research Support; Dexcom, Inc., Eli Lilly and Company, Insulet Corporation, Novo Nordisk. C.Geno rasmussen: None. A.Gerard gonzalez: n/a. J.K.Snell-bergeon: Stock/Shareholder; GlaxoSmithKline plc. Funding NIH grant P30-DK116073