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ORIGINAL RESEARCH article

Front. Clin. Diabetes Healthc.
Sec. Diabetes Inequalities
Volume 5 - 2024 | doi: 10.3389/fcdhc.2024.1417287
This article is part of the Research Topic Ethnic Inequalities in Diabetes Care and Outcomes View all 4 articles

Technology Usage and Glycaemic Outcomes in a Single Tertiary Centre with ann Ethnically Diverse and Socioeconomically Deprived Cohort of Children with Type 1 Diabetes Mellitus

Provisionally accepted
India Dickinson India Dickinson 1*Ankita Gupta Ankita Gupta 1Gar Mun Lau Gar Mun Lau 1Pranav Viswanath Iyer Pranav Viswanath Iyer 1*John Pemberton John Pemberton 2Suma Uday Suma Uday 2,3*
  • 1 University of Birmingham, Birmingham, England, United Kingdom
  • 2 Birmingham Children's Hospital NHS Foundation Trust, Birmingham, United Kingdom
  • 3 Institute of Metabolism and Systems Research (IMSR), College of Medical and Dental Sciences, University of Birmingham, Birmingham, England, United Kingdom

The final, formatted version of the article will be published soon.

    Background: The UK National Paediatric Diabetes Audit (NPDA) data reports disparities in Haemoglobin A1c (HbA1c) levels among children and young people (CYP) with Type 1 Diabetes (T1D), with higher levels in those of Black ethnic background and lower socioeconomic status who have less access to technology. We investigate HbA1c differences in a T1D cohort with higher than national average technology uptake where > 60% come from an ethnic minority and/or socioeconomically deprived population. Design & Methods: Retrospective cross-sectional study investigating the influence of demographic factors, technology use, and socioeconomic status (SES) on glycaemic outcomes. The study population was 222 CYP with T1D who attended the diabetes clinic in 2022 at our centre. Results: Among 222 CYP, 60% were of ethnic minority (Asian, Black, Mixed and Other were 32%, 12%, 6% and 10% respectively) and 40% of white heritage. 94% used Continuous Glucose Monitoring (CGM) and 60% used Continuous Subcutaneous Insulin Infusion (CSII) via open or closed loop. 6% used Self-Monitoring of Blood Glucose (SMBG) and Multiple Daily Injections (MDI), 34% used CGM and MDI, 38% used CGM and CSII and 22% used Hybrid Closed-Loop (HCL) systems. Significant differences in HbA1c across therapy groups (p < 0.001) was noted with lowest HbA1c in HCL group (55 mmol/mol; p <0.001). Despite adjusting for therapy type, the Black group had higher HbA1c than their white and Asian counterparts (p<0.001). CYP from the most deprived tertile had significantly higher HbA1c levels (p < 0.001) but the difference was not sustained after adjusting for therapy type. Conclusion: Advanced diabetes technologies improve glycaemic control. Whilst equalising technology access mitigates socioeconomic disparities in HbA1c, CYP from Black ethnic background continue to display a higher HbA1c.

    Keywords: type 1 diabetes, inequity, continuous insulin delivery, Continuous glucose monitor (CGM), Social deprivation, Ethnic minorites

    Received: 14 Apr 2024; Accepted: 11 Dec 2024.

    Copyright: © 2024 Dickinson, Gupta, Lau, Iyer, Pemberton and Uday. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence:
    India Dickinson, University of Birmingham, Birmingham, B15 2TT, England, United Kingdom
    Pranav Viswanath Iyer, University of Birmingham, Birmingham, B15 2TT, England, United Kingdom
    Suma Uday, Birmingham Children's Hospital NHS Foundation Trust, Birmingham, United Kingdom

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