The impact of socio‐economic deprivation on access to diabetes technology in adults with type 1 diabetes. Issue 10 (30th June 2022)

• Record Type: Journal Article
• Authors: Fallon, Ciara; Jones, Emma; Oliver, Nick; Reddy, Monika; Avari, Parizad
• Is Part Of: Diabetic medicine. Volume 39:Issue 10(2022)
• Page Start: n/a
• Page End: n/a
• Publication Date: 2022-06-30
• Subjects: continuous glucose monitoring -- diabetes technology -- health inequalities -- socio‐economic deprivation -- structured education -- type 1 diabetes; Diabetes -- Periodicals; 616.462
• DOI: 10.1111/dme.14906
• Languages: English
• ISSNs: 0742-3071

Abstract

Abstract: Background: With advances in technology, there is an emerging concern that inequalities exist in provision and diabetes outcomes in areas of greater deprivation. We assess the relationship between socio‐economic status and deprivation with access to diabetes technology and their outcomes in adults with type 1 diabetes. Methods: Retrospective, observational analysis of adults attending a tertiary centre, comprising three urban hospitals in the UK. Socio‐economic deprivation was assessed by the English Indices of Deprivation 2019. Data analysis was performed using one‐way ANOVAs and chi‐squared tests. Results: In total, 1631 adults aged 44 ± 15 years and 758 (47%) women were included, with 391 (24%) using continuous subcutaneous insulin infusion, 312 (19%) using real‐time continuous glucose monitoring and 558 (34%) using intermittently scanned continuous glucose monitoring. The highest use of diabetes technology was in the least deprived quintile compared to the most deprived quintile (67% vs. 45%, respectively; p < 0.001). HbA1c outcomes were available in 400 participants; no association with deprivation was observed ( p = 0.872). Participation in structured education was almost twice as high from the most deprived to the least deprived groups (23% vs. 43%; p < 0.001). Adults with white or mixed ethnicity were more likely to use technology compared to black ethnicity (60% vs. 40%; p < 0.001). Conclusions: Adults living in the most deprived quintile had less technology use. Irrespective of socio‐economic status or ethnicity, glycaemia was positively affected in all groups. It is imperative that health disparities are further addressed.