scholarly journals Barriers to Technology Use and Endocrinology Care for Underserved Communities With Type 1 Diabetes

Diabetes Care ◽  
2021 ◽  
pp. dc202753
Author(s):  
Ashby F. Walker ◽  
Korey K. Hood ◽  
Matthew J. Gurka ◽  
Stephanie L. Filipp ◽  
Claudia Anez-Zabala ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Technology Use ◽  
Underserved Communities ◽  
Barriers To Technology Use ◽  
Barriers To Technology

58-LB: Barriers to Technology Use for Underserved Communities with Type 1 Diabetes

Diabetes ◽  
2020 ◽  
Vol 69 (Supplement 1) ◽  
pp. 58-LB
Author(s):  
ASHBY F. WALKER ◽  
NICOLAS CUTTRISS ◽  
MICHAEL J. HALLER ◽  
STEPHANIE L. FILIPP ◽  
KATARINA YABUT ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Technology Use ◽  
Underserved Communities ◽  
Barriers To Technology Use ◽  
Barriers To Technology

861-P: Barriers to Technology Use in Pediatric Patients with Type 1 Diabetes

Diabetes ◽  
2019 ◽  
Vol 68 (Supplement 1) ◽  
pp. 861-P
Author(s):  
DAVID TSAI ◽  
MARK W. REID ◽  
JAQUELIN J. FLORES GARCIA ◽  
JENNIFER RAYMOND
Keyword(s):  
Type 1 Diabetes ◽  
Technology Use ◽  
Pediatric Patients ◽  
Barriers To Technology Use ◽  
Barriers To Technology

A Decade of Disparities in Diabetes Technology Use and HbA1c in Pediatric Type 1 Diabetes: A Trans-Atlantic Comparison

2020 ◽  
Author(s):  
Ananta Addala ◽  
Marie Auzanneau ◽  
Kellee Miller ◽  
Werner Maier ◽  
Nicole Foster ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Technology Use ◽  
Hemoglobin A1c ◽  
Diabetes Technology ◽  
Design And Methods ◽  
Relationship Of ◽  
The Relationship ◽  
Pediatric Type 1 Diabetes

<b>Objective:</b> As diabetes technology use in youth increases worldwide, inequalities in access may exacerbate disparities in hemoglobin A1c (HbA1c). We hypothesized an increasing gap in diabetes technology use by socioeconomic status (SES) would be associated with increased HbA1c disparities. <p> </p> <p><b>Research Design and Methods: </b>Participants aged <18 years with diabetes duration ≥1 year in the Type 1 Diabetes Exchange (T1DX, US, n=16,457) and Diabetes Prospective Follow-up (DPV, Germany, n=39,836) registries were categorized into lowest (Q1) to highest (Q5) SES quintiles. Multiple regression analyses compared the relationship of SES quintiles with diabetes technology use and HbA1c from 2010-2012 and 2016-2018. </p> <p> </p> <p><b>Results: </b>HbA1c was higher in participants with lower SES (in 2010-2012 & 2016-2018, respectively: 8.0% & 7.8% in Q1 and 7.6% & 7.5% in Q5 for DPV; and 9.0% & 9.3% in Q1 and 7.8% & 8.0% in Q5 for T1DX). For DPV, the association between SES and HbA1c did not change between the two time periods, whereas for T1DX, disparities in HbA1c by SES increased significantly (p<0.001). After adjusting for technology use, results for DPV did not change whereas the increase in T1DX was no longer significant.</p> <p> </p> <p><b>Conclusions: </b>Although causal conclusions cannot be drawn, diabetes technology use is lowest and HbA1c is highest in those of the lowest SES quintile in the T1DX and this difference for HbA1c broadened in the last decade. Associations of SES with technology use and HbA1c were weaker in the DPV registry. </p>

Diabetes Technology Experiences Among Latinx and Non-Latinx Youth with Type 1 Diabetes

2021 ◽  
pp. 193229682110292
Author(s):  
David Tsai ◽  
Jaquelin Flores Garcia ◽  
Jennifer L. Fogel ◽  
Choo Phei Wee ◽  
Mark W. Reid ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Young People ◽  
Technology Use ◽  
Private Insurance ◽  
Spanish Speaking ◽  
Positive Attitudes ◽  
Diabetes Technology ◽  
English Speaking ◽  
Continuous Glucose Monitors

Background: Diabetes technologies, such as insulin pumps and continuous glucose monitors (CGM), have been associated with improved glycemic control and increased quality of life for young people with type 1 diabetes (T1D); however, few young people use these devices, especially those from minority ethnic groups. Current literature predominantly focuses on white patients with private insurance and does not report experiences of diverse pediatric patients with limited resources. Methods: To explore potential differences between Latinx and non-Latinx patients, English- and Spanish-speaking young people with T1D ( n = 173, ages 11-25 years) were surveyed to assess attitudes about and barriers to diabetes technologies using the Technology Use Attitudes and Barriers to Device Use questionnaires. Results: Both English- and Spanish-speaking participants who identified as Latinx were more likely to have public insurance ( P = .0001). English-speaking Latinx participants reported higher Hemoglobin A1c values ( P = .003), less CGM use ( P = .002), and more negative attitudes about technology (generally, P = .003; and diabetes-specific, P < .001) than either non-Latinx or Spanish-speaking Latinx participants. Barriers were encountered with equivalent frequency across groups. Conclusions: Latinx English-speaking participants had less positive attitudes toward general and diabetes technology than Latinx Spanish-speaking and non-Latinx English-speaking peers, and differences in CGM use were associated with socioeconomic status. Additional work is needed to design and deliver diabetes interventions that are of interest to and supportive of patients from diverse ethnic and language backgrounds.

scholarly journals Diabetes Technology Use for Management of Type 1 Diabetes Is Associated With Fewer Adverse COVID-19 Outcomes: Findings From the T1D Exchange COVID-19 Surveillance Registry

Diabetes Care ◽  
2021 ◽  
pp. dc210074
Author(s):  
Nudrat Noor ◽  
Osagie Ebekozien ◽  
Laura Levin ◽  
Sheri Stone ◽  
David P. Sparling ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Technology Use ◽  
Diabetes Technology

scholarly journals Technology Use, Comfort, and Interest: A comparison between caregiver and older adult populations

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 662-663
Author(s):  
Sarah Hubner ◽  
Akankshya Chataut ◽  
Marcia Shade ◽  
Ann Fruhling ◽  
Natalie Manley ◽  
...  
Keyword(s):  
Focus Groups ◽  
Older Adult ◽  
Technology Use ◽  
Personal Autonomy ◽  
Well Being ◽  
Community Dwelling ◽  
Isolated Populations ◽  
Major Barrier ◽  
Barriers To Technology Use ◽  
Barriers To Technology

Abstract Remaining community-dwelling is a goal for most aging adults; however, this may necessitate assistance from caregivers. To reduce burden and improve adult autonomy, recent technological advancements have provided various supports. These advancements may improve quality of life (QOL) while also enhancing psychological/physical well-being for adults and caregivers. To investigate relationships between technology, QOL, and caregiver burden, needs assessments with focus groups were utilized. Four older adult focus groups (N=20) and three caregiver focus groups (N=12) were convened. Older adult participants, aged 64-83 years (M=73.1,SD=5.3), were 50% female and generally white (90%). Caregiver participants, aged 31-78 years (M=61.9,SD=12.6), were majority female (83%) and generally white (92%). Because of the ongoing COVID-19 pandemic, focus groups were conducted via Zoom video-conferencing. Thematic analyses revealed major themes of privacy, transportation, and interest in streamlined technologies. Throughout groups, privacy was consistently described; participants were either 1) apathetic, noting absence of privacy or 2) hyper-vigilant about security, citing privacy as a major barrier to utilization. Transportation, specifically self-driving/enhanced vehicles, emerged as a focus for future technologies as a means to reduce care burden and improve personal autonomy/QOL. In general, participants noted that major barriers to technology use included complexity and cost; persons expressed interest in simpler/cheaper devices. This study indicates varied interest in technology while exposing barriers to use. Additionally, the methodology demonstrates the utility of technology (e.g., Zoom) in accessing vulnerable and/or isolated populations. Overall, understanding barriers to technology use and adoption informs upcoming developments and may improve accessibility and usefulness in future systems/devices.

scholarly journals Racial-Ethnic Inequity in Young Adults With Type 1 Diabetes

2020 ◽  
Vol 105 (8) ◽  
pp. e2960-e2969 ◽  
Author(s):  
Shivani Agarwal ◽  
Lauren G Kanapka ◽  
Jennifer K Raymond ◽  
Ashby Walker ◽  
Andrea Gerard-Gonzalez ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Young Adults ◽  
Technology Use ◽  
Self Management ◽  
Diabetes Distress ◽  
Diabetes Technology ◽  
Racial Ethnic ◽  
Hispanic White ◽  
Hba1c Levels

Abstract Context Minority young adults (YA) currently represent the largest growing population with type 1 diabetes (T1D) and experience very poor outcomes. Modifiable drivers of disparities need to be identified, but are not well-studied. Objective To describe racial-ethnic disparities among YA with T1D and identify drivers of glycemic disparity other than socioeconomic status (SES). Design Cross-sectional multicenter collection of patient and chart-reported variables, including SES, social determinants of health, and diabetes-specific factors, with comparison between non-Hispanic White, non-Hispanic Black, and Hispanic YA and multilevel modeling to identify variables that account for glycemic disparity apart from SES. Setting Six diabetes centers across the United States. Participants A total of 300 YA with T1D (18-28 years: 33% non-Hispanic White, 32% non-Hispanic Black, and 34% Hispanic). Main Outcome Racial-ethnic disparity in HbA1c levels. Results Non-Hispanic Black and Hispanic YA had lower SES, higher HbA1c levels, and much lower diabetes technology use than non-Hispanic White YA (P &lt; 0.001). Non-Hispanic Black YA differed from Hispanic, reporting higher diabetes distress and lower self-management (P &lt; 0.001). After accounting for SES, differences in HbA1c levels disappeared between non-Hispanic White and Hispanic YA, whereas they remained for non-Hispanic Black YA (+ 2.26% [24 mmol/mol], P &lt; 0.001). Diabetes technology use, diabetes distress, and disease self-management accounted for a significant portion of the remaining non-Hispanic Black–White glycemic disparity. Conclusion This study demonstrated large racial-ethnic inequity in YA with T1D, especially among non-Hispanic Black participants. Our findings reveal key opportunities for clinicians to potentially mitigate glycemic disparity in minority YA by promoting diabetes technology use, connecting with social programs, and tailoring support for disease self-management and diabetes distress to account for social contextual factors.

851-P: Technology Use by Age and Region in Adults with Type 1 Diabetes (T1D) in the SAGE Study

Diabetes ◽  
2020 ◽  
Vol 69 (Supplement 1) ◽  
pp. 851-P
Author(s):  
STEVEN EDELMAN ◽  
DANIELA BRUTTOMESSO ◽  
KELLY L. CLOSE ◽  
ANDRE G. VIANNA ◽  
FELIPE LAUAND ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Technology Use

scholarly journals A Decade of Disparities in Diabetes Technology Use and HbA1c in Pediatric Type 1 Diabetes: A Transatlantic Comparison

Diabetes Care ◽  
2020 ◽  
Vol 44 (1) ◽  
pp. 133-140 ◽  
Author(s):  
Ananta Addala ◽  
Marie Auzanneau ◽  
Kellee Miller ◽  
Werner Maier ◽  
Nicole Foster ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Technology Use ◽  
Diabetes Technology ◽  
Transatlantic Comparison ◽  
Pediatric Type 1 Diabetes
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