Improved Glycemic Outcomes With Diabetes Technology Use Independent of Socioeconomic Status in Youth With Type 1 Diabetes
K Lomax, Craig E. Taplin, Mary B. Abraham, Grant J. Smith, Aveni Haynes, Ella Zomer, Katrina L. Ellis, Helen Clapin, Sophia Zoungas, Alicia J. Jenkins, Jennifer Harrington, Martin de Bock, Timothy W. Jones, Elizabeth A. Davis, Australasian Diabetes Data Network (ADDN) Study Group, Kym Anderson, Sof Andrikopoulos, Geoffrey Ambler, Helen L. Barrett, Jenny Batch, Philip Bergman, Fergus Cameron, Louise Conwell, Andrew Cotterill, Chris Cooper, Jennifer Couper, Maria E. Craig, Elizabeth A. Davis, Martin de Bock, Jan Fairchild, Gerry Fegan, Spiros Fourlanos, Sarah J. Glastras, Peter Goss, Leonie Gray, Peter S. Hamblin, Paul L. Hofman, Dianne Jane Holmes‐Walker, Tony Huynh, Sonia R. Isaacs, Craig Jefferies, Stephanie Johnson, Timothy W. Jones, Jeff Kao, Bruce R. King, Antony Lafferty, Jane Makin, Michelle Martin, Robert McCrossin, Kris Neville, Mark Pascoe, Ryan Paul, Dorota Pawlak, Alexia Peña, Liza Phillips, Darrell Price, Christine Rodda, David Simmons, Richard Sinnott, Carmel E. Smart, Anthony Stell, Monique Stone, Steve Stranks, Elaine Tham, Barbara J. Waddell, Glenn M. Ward, Benjamin J. Wheeler, Helen Woodhead, Anthony Zimmermann
Abstract
OBJECTIVE: Technology use in type 1 diabetes (T1D) is impacted by socioeconomic status (SES). This analysis explored relationships between SES, glycemic outcomes, and technology use. RESEARCH DESIGN AND METHODS: A cross-sectional analysis of HbA1c data from 2,822 Australian youth with T1D was undertaken. Residential postcodes were used to assign SES based on the Index of Relative Socio-Economic Disadvantage (IRSD). Linear regression models were used to evaluate associations among IRSD quintile, HbA1c, and management regimen. RESULTS: Insulin pump therapy, continuous glucose monitoring, and their concurrent use were associated with lower mean HbA1c across all IRSD quintiles (P < 0.001). There was no interaction between technology use and IRSD quintile on HbA1c (P = 0.624), reflecting a similar association of lower HbA1c with technology use across all IRSD quintiles. CONCLUSIONS: Technology use was associated with lower HbA1c across all socioeconomic backgrounds. Socioeconomic disadvantage does not preclude glycemic benefits of diabetes technologies, highlighting the need to remove barriers to technology access.