JMIR Publications

ABSTRACT

Background:

Prior work has revealed racial disparities in both type 1 diabetes (T1D) outcomes and in rates of technology use among Hispanic children compared to non-Hispanic white (NHW) children.

Objective:

We aimed to investigate use of insulin pumps and continuous glucose monitoring (CGM) devices among Spanish-speaking children in our clinic population and to identify specific barriers to technology use.

Methods:

First, we assessed rates and patterns of diabetes technology use (insulin pumps and CGM devices) in a sample of 76 children (38 Spanish-speaking and 38 NHW). We compared rates of technology use, average length of time between diabetes diagnosis and initiation of insulin pump and/or CGM device, and rates of discontinuation of these devices between the Spanish-speaking and NHW children. Second, to understand specific barriers to technology use, we compared responses to a questionnaire assessing decision-making about insulin pumps.

Results:

Spanish-speaking patients had lower rates of insulin pump use, even after controlling for age, gender, age at diagnosis and type of health insurance. Spanish-speaking participants were more likely to report concerns over learning to use an insulin pump, questions about how it works, and concerns about keeping it attached. Furthermore, the Spanish-speaking children were more likely to discontinue insulin pumps after starting them.

Conclusions:

These data confirm ethnic disparities in insulin pump use among children with T1D and provide new insights about insulin pump discontinuation among Spanish-speaking children. Our findings suggest a need for improved patient education about insulin pump technology in general, and improved support for Spanish-speaking families with T1D after initiation of pump therapy.