Racial and Ethnic Disparities in Rates of Continuous Glucose Monitor Initiation and Continued Use in Children With Type 1 Diabetes

OBJECTIVE Racial/ethnic disparities in continuous glucose monitor (CGM) use exist among children with type 1 diabetes. It is not known whether differential rates of device initiation or sustained use are the cause of this disparity. Our objective was to compare CGM initiation rates and continued use among non-Hispanic White (NHW), non-Hispanic Black (NHB), and Hispanic children. RESEARCH DESIGN AND METHODS We conducted a retrospective review including children with type 1 diabetes attending the Children's Hospital of Philadelphia between 1 January 2015 and 31 December 2018. RESULTS Of 1,509 eligible children, 726 (48%) started CGM during the study period. More NHW (54%) than NHB (31%) and Hispanic (33%) children started CGM (P < 0.001). One year after starting, fewer NHB (61%) than NHW (86%) and Hispanic (85%) children were using CGM (P < 0.001). CONCLUSIONS Lower CGM use in NHB children was due to lower rates of device initiation and higher rates of discontinuation. Interventions to address both of these barriers are needed to reduce disparities in CGM use.

Automated summary

Racial/ethnic disparities exist in continuous glucose monitor (CGM) use among children with type 1 diabetes. The study found that lower CGM use in non-Hispanic Black children was due to lower rates of device initiation and higher rates of discontinuation. Interventions are needed to address both of these barriers in order to reduce disparities in CGM use.