Technology usage and glycaemic outcomes in a single tertiary centre with an ethnically diverse and socioeconomically deprived cohort of children with type 1 diabetes mellitus
BackgroundThe 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 techno...
Saved in:
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2025-01-01
|
| Series: | Frontiers in Clinical Diabetes and Healthcare |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fcdhc.2024.1417287/full |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1841553871018655744 |
|---|---|
| author | India Dickinson Ankita Gupta Gar Mun Lau Pranav Viswanath Iyer John Stuart Pemberton Suma Uday Suma Uday |
| author_facet | India Dickinson Ankita Gupta Gar Mun Lau Pranav Viswanath Iyer John Stuart Pemberton Suma Uday Suma Uday |
| author_sort | India Dickinson |
| collection | DOAJ |
| description | BackgroundThe 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 & methodsRetrospective 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 a single tertiary paediatric diabetes centre.ResultsAmong 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.ConclusionAdvanced 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. The study underscores the necessity of fair technology distribution and further research into elevated HbA1c levels among Black CYP using advanced diabetes technology. |
| format | Article |
| id | doaj-art-1cdc0879da364215ad2e0931786db8a5 |
| institution | Kabale University |
| issn | 2673-6616 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Clinical Diabetes and Healthcare |
| spelling | doaj-art-1cdc0879da364215ad2e0931786db8a52025-01-09T06:10:11ZengFrontiers Media S.A.Frontiers in Clinical Diabetes and Healthcare2673-66162025-01-01510.3389/fcdhc.2024.14172871417287Technology usage and glycaemic outcomes in a single tertiary centre with an ethnically diverse and socioeconomically deprived cohort of children with type 1 diabetes mellitusIndia Dickinson0Ankita Gupta1Gar Mun Lau2Pranav Viswanath Iyer3John Stuart Pemberton4Suma Uday5Suma Uday6School of Medical and Dental Sciences, University of Birmingham, Birmingham, United KingdomSchool of Medical and Dental Sciences, University of Birmingham, Birmingham, United KingdomSchool of Medical and Dental Sciences, University of Birmingham, Birmingham, United KingdomSchool of Medical and Dental Sciences, University of Birmingham, Birmingham, United KingdomDepartment of Endocrinology and Diabetes, Birmingham Women’s and Children’s NHS Foundation Trust, Birmingham, United KingdomDepartment of Endocrinology and Diabetes, Birmingham Women’s and Children’s NHS Foundation Trust, Birmingham, United KingdomDepartment of Metabolism and Systems Science, College of Medical and Dental Sciences, University of Birmingham, Birmingham, United KingdomBackgroundThe 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 & methodsRetrospective 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 a single tertiary paediatric diabetes centre.ResultsAmong 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.ConclusionAdvanced 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. The study underscores the necessity of fair technology distribution and further research into elevated HbA1c levels among Black CYP using advanced diabetes technology. https://www.frontiersin.org/articles/10.3389/fcdhc.2024.1417287/fulltype 1 diabetesinequitycontinuous subcutaneous insulin infusioncontinuous glucose monitor (CGM)social deprivationethnic minorites |
| spellingShingle | India Dickinson Ankita Gupta Gar Mun Lau Pranav Viswanath Iyer John Stuart Pemberton Suma Uday Suma Uday Technology usage and glycaemic outcomes in a single tertiary centre with an ethnically diverse and socioeconomically deprived cohort of children with type 1 diabetes mellitus Frontiers in Clinical Diabetes and Healthcare type 1 diabetes inequity continuous subcutaneous insulin infusion continuous glucose monitor (CGM) social deprivation ethnic minorites |
| title | Technology usage and glycaemic outcomes in a single tertiary centre with an ethnically diverse and socioeconomically deprived cohort of children with type 1 diabetes mellitus |
| title_full | Technology usage and glycaemic outcomes in a single tertiary centre with an ethnically diverse and socioeconomically deprived cohort of children with type 1 diabetes mellitus |
| title_fullStr | Technology usage and glycaemic outcomes in a single tertiary centre with an ethnically diverse and socioeconomically deprived cohort of children with type 1 diabetes mellitus |
| title_full_unstemmed | Technology usage and glycaemic outcomes in a single tertiary centre with an ethnically diverse and socioeconomically deprived cohort of children with type 1 diabetes mellitus |
| title_short | Technology usage and glycaemic outcomes in a single tertiary centre with an ethnically diverse and socioeconomically deprived cohort of children with type 1 diabetes mellitus |
| title_sort | technology usage and glycaemic outcomes in a single tertiary centre with an ethnically diverse and socioeconomically deprived cohort of children with type 1 diabetes mellitus |
| topic | type 1 diabetes inequity continuous subcutaneous insulin infusion continuous glucose monitor (CGM) social deprivation ethnic minorites |
| url | https://www.frontiersin.org/articles/10.3389/fcdhc.2024.1417287/full |
| work_keys_str_mv | AT indiadickinson technologyusageandglycaemicoutcomesinasingletertiarycentrewithanethnicallydiverseandsocioeconomicallydeprivedcohortofchildrenwithtype1diabetesmellitus AT ankitagupta technologyusageandglycaemicoutcomesinasingletertiarycentrewithanethnicallydiverseandsocioeconomicallydeprivedcohortofchildrenwithtype1diabetesmellitus AT garmunlau technologyusageandglycaemicoutcomesinasingletertiarycentrewithanethnicallydiverseandsocioeconomicallydeprivedcohortofchildrenwithtype1diabetesmellitus AT pranavviswanathiyer technologyusageandglycaemicoutcomesinasingletertiarycentrewithanethnicallydiverseandsocioeconomicallydeprivedcohortofchildrenwithtype1diabetesmellitus AT johnstuartpemberton technologyusageandglycaemicoutcomesinasingletertiarycentrewithanethnicallydiverseandsocioeconomicallydeprivedcohortofchildrenwithtype1diabetesmellitus AT sumauday technologyusageandglycaemicoutcomesinasingletertiarycentrewithanethnicallydiverseandsocioeconomicallydeprivedcohortofchildrenwithtype1diabetesmellitus AT sumauday technologyusageandglycaemicoutcomesinasingletertiarycentrewithanethnicallydiverseandsocioeconomicallydeprivedcohortofchildrenwithtype1diabetesmellitus |