Young people with Type 1 Diabetes Mellitus encounter daily struggles with titrating insulin to achieve adequate glycemic control. Technology is improving with insulin pumps and continuous glucose monitoring (CGM) however access to it remains variable across the UK. Those from ethnic minorities and deprived areas are less likely to access technology and more susceptible to developing complications of diabetes with worsening HbA1c’s. Understanding the reasons for health inequalities is essential to facilitate use of technology in this population.
Aim: To review the use of technology across our diverse population of young people with T1DM.
Method: We prospectively invited families over a 3 month period to participate in a voluntary questionnaire during clinics or by post to review the use of technology.
Analysis: Ninety Eight families responded and 88 questionnaires were included in the analysis (5- Type 2 DM, 1- duplicate,4- incomplete excluded). We found that 35%(31/88) used an Insulin Pump and 60% (53/88) CGM. Those receiving pump therapy and CGM achieved the best HbA1c (<8%) with 70.9%(22/31) and 76% (40/53) respectively. Data was divided into two groups; those who spoke English as a first language((EFL) n=65) and English as a second language ((ESL)n=23). Findings are summarised in Table 1. The difference between access to mobile phones was statistically significant (P<0.005) between the groups with 82% (18/23) in ESL compared with 97% (63/65) in EFL. Access to a home computer was similar (ESL- 78% and EFL- 88%) however a difference exists in downloading and reviewing blood glucose patterns with ESL achieving 26% (6/23) whilst EFL achieved 40% (26/65). CGM was accessed in only 48%(11/23) in ESL compared with 65%(42/65) in EFL. Time in Range(TIR) was reduced and statistically significant (P<0.05) with TIR< 50% in 58% (11/19) in ESL compared with 32% (18/57) in EFL.
|English 1st Language (n=65)||English 2nd Language (n=23)||P value|
|Home Computer||57 (88%)||18 (78%)||0.273|
|Phone:||63 (97%)||18 (82%)|
|<0.005Insulin Pump||21 (32%)||9 (39%)||0.553|
|CGM||42 (65%)||11 (48%)||0.157|
|Downloads||26 (40%)||6 (26%)||0.233|
|Time in range: < 50%||18 (32%)||11 (58%)||<0.05|
|HbA1c<8% (64mmol/mol)||44 (68%)||16 (69%)||0.868|
Conclusion: Our study demonstrates a clear reduction in access to technology including phones within our ESL population with significantly decreased TIR. Technology in T1DM improves HbA1c however families, especially in this ESL population need targeted support to achieve this.
15 Sep 2022 - 17 Sep 2022