Insulin Pump Use in Children with Type 1 Diabetes: Over a Decade of Disparities
Insulin Pump Use in Children with Type 1 Diabetes: Over a Decade of Disparities
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DOI：
10.1016/j.pedn.2020.08.007
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发表时间：
2020-11-01
影响因子：
2.4
通讯作者：
Hawkes, Colin P.
中科院分区：
文献类型：
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作者：
Lipman, Terri H.;Willi, Steven M.;Hawkes, Colin P.
目的：1型糖尿病(T1D)儿童的预后和治疗存在种族差异。本研究的目的是研究在大型城市糖尿病中心就诊的非西班牙裔白人(Nhw)、非西班牙裔黑人(Nhb)和西班牙裔儿童使用胰岛素泵的时间趋势。这项研究回顾了2005年按种族(nhw/nhb)和2011-2019年按种族/民族(nhw/nhb/西班牙裔)划分的胰岛素泵使用情况。2011-2019年的人口学数据(年龄、性别、糖尿病病程)和最新的血红蛋白A1c也被提取。结果：2005年，NHW儿童使用胰岛素泵的可能性是NHB儿童的两倍。从2011年到2019年，与NHB儿童相比，NHW儿童的优势比增加到2.5。西班牙裔儿童使用胰岛素泵的几率也高于NHB。保险状况(政府和私人)对这些趋势的影响很小，2011年、2013年、2017年、2019年，NHW儿童接受胰岛素泵治疗的可能性一直高于NHB儿童(p<；0.001)。结论：我们已经证明，在过去15年中，胰岛素泵使用方面的种族差异一直存在，而且不是由SES决定的。糖尿病治疗中的这种不平等可能是导致NHB儿童血糖控制较差和糖尿病并发症发生率较高的原因之一。(C)2020 Elsevier Inc.保留所有权利。
Purpose: Racial disparities have been shown in outcomes and treatment of children with type 1 diabetes (T1D). The purpose of this study was to examine temporal trends in insulin pump use among non-Hispanic white (NHW), non-Hispanic black (NHB) and Hispanic children attending a large urban diabetes center.This study was a retrospective chart review of insulin pump usage by race (NHW/ NHB) in 2005, and race/ethnicity (NHW/NHB/Hispanic) in 2011-2019. Demographic data (age, sex, diabetes duration, SES) and most recent hemoglobin A1c were also abstracted in 2011-2019.Results: In 2005, NHW children were twice as likely to use an insulin pump as NHB children. From 2011 to 2019, the odds ratio increased to 2.5 for NHW compared to NHB children. The odds of Hispanic children using insulin pumps were also higher than NHB. Insurance status (government versus private), a surrogate for SES, had very little influence on these trends, with NHW children consistently more likely than NHB children to be treated with insulin pumps in 2011, 2013, 2017, 2019 (p < 0.001).Conclusions: We have demonstrated that racial disparities in insulin pump use have persisted over the past 15 years, and are not determined by SES. This inequity in diabetes treatment may be playing a role in the poorer glycemic control and higher rates of diabetes complications in NHB children. (C) 2020 Elsevier Inc. All rights reserved.