Journal
ACTA DIABETOLOGICA
Volume 54, Issue 1, Pages 63-71Publisher
SPRINGER-VERLAG ITALIA SRL
DOI: 10.1007/s00592-016-0912-7
Keywords
Insulin pump; Utilization; Epidemiology; Ethnicity; Socioeconomic position
Categories
Funding
- Health Research South, Dunedin School of Medicine, University of Otago
- Otago Medical Research Fund
- Kelliher Charitable Trust Summer Scholarship Award
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Insulin pumps have been publically funded in New Zealand since 2012 for patients who meet certain clinical criteria; however, the patterns of utilization have not been described. We undertook a nationwide study to estimate the annual proportions of patients with type 1 diabetes mellitus who used a pump between 2012 and 2014, overall, and according to sex, age, ethnicity, socioeconomic position, and region. We used data from the New Zealand Virtual Diabetes Register and routinely collected national demographic, health, and pharmaceutical dispensing data from the Ministry of Health to identify patients with type 1 diabetes and to calculate the overall, and subgroup, proportions using pumps. Between 2012 and 2014, funded pump use among patients with type 1 diabetes (n = 13,727) increased from 1.8 to 9.3 % overall; however, there were differences in uptake according to demographic characteristics and region. In 2014, proportionate pump use was significantly higher in females versus males (adjusted odds ratio (OR) 2.0 [95 % confidence interval 1.8-2.3]), in those aged < 20 years, and in some regions. MAori (indigenous people), Pacific, and Asian patients were significantly less likely to use pumps than New Zealand Europeans (ORs 0.30 [0.23-0.41], 0.26 [0.14-0.46], 0.22 [0.14-0.35], respectively), as were those in the most versus the least deprived socioeconomic decile (OR 0.36 [0.25-0.52]). It is essential to explore the factors driving differential insulin pump uptake, in both New Zealand and elsewhere, if all patients are to have equal opportunity to benefit from intensive diabetes management.
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