Insulin pump use in pediatric patients with type 1 diabetes mellitus and demographic disparity

Abstract

Aim: To assess the effectiveness of insulin pump therapy in improving glycemic control and to determine the frequency of insulin pump use among our type 1 diabetes (T1DM) patients and the factors associated with its use.

Methods: We conducted a retrospective chart review of 487 patients aged 2–18 years with a diagnosis of T1DM who attended UT pediatric endocrinology clinics between July 2020 and October 2023. Data collected included demographics, insurance type, and HbA1c values at baseline, 6 months after pump initiation, and at the most recent follow-up.

Results: Data show that 169 out of 487 patients (34.7 %) were prescribed insulin pumps, ‎with a mean age 13.72 ± 3.8 years, and 54.4% were males. Insulin pump use was 59% among non-Hispanic whites, 21.6% among Hispanics, 16.2% among African Americans, 23% among other racial and ethnic groups, 2.9% among Spanish-speaking patients, 20.9% among patients with Medicaid, and 52.8% among patients with private insurance. Data for baseline HbA1c and 6 months after initiation of insulin pump were available for 83 patients and showed a mean baseline HbA1c 7.98% and 6-month HbA1c 7.72% (P < 0.05). Median HbA1c in the most recent follow-up visit among insulin pump users was 7.8 % vs 9.4% (p < 0.001) among patients on multiple daily injections.

Conclusions: Results show a significant improvement in ‎hemoglobin A1c after starting an insulin pump, ‎indicating better glycemic control. Also, the data ‎demonstrate demographic disparities in insulin ‎pump use among pediatric patients with T1DM. ‎Data showed that insulin pump use was ‎significantly lower in racial/ethnic minorities, ‎Spanish-speaking patients, and in patients on public health insurance. Further research is ‎needed to identify and address barriers to ‎diabetes technology use.‎

Key messages: • Use of technology in pediatric diabetes.

• Technology and demographic disparity.

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BibTeX RIS

BibTeX

@article{mahmoud2026insulin,
  title = {{Insulin pump use in pediatric patients with type 1 diabetes mellitus and demographic disparity}},
  author = {S Mahmoud and A Shah and M Yafi},
  journal = {The European Journal of Public Health},
  year = {2026},
  month = oct,
  doi = {10.1093/eurpub/ckag169.1047},
  url = {https://doi.org/10.1093/eurpub/ckag169.1047},
  note = {CC BY-NC 4.0},
}

RIS

TY  - JOUR
TI  - Insulin pump use in pediatric patients with type 1 diabetes mellitus and demographic disparity
AU  - S Mahmoud
AU  - A Shah
AU  - M Yafi
PY  - 2026
DA  - 2026/10/01
JO  - The European Journal of Public Health
DO  - 10.1093/eurpub/ckag169.1047
UR  - https://doi.org/10.1093/eurpub/ckag169.1047
AB  - Aim: To assess the effectiveness of insulin pump therapy in improving glycemic control and to determine the frequency of insulin pump use among our type 1 diabetes (T1DM) patients and the factors associated with its use.  Methods: We conducted a retrospective chart review of 487 patients aged 2–18 years with a diagnosis of T1DM who attended UT pediatric endocrinology clinics between July 2020 and October 2023. Data collected included demographics, insurance type, and HbA1c values at baseline, 6 months after pump initiation, and at the most recent follow-up.  Results: Data show that 169 out of 487 patients (34.7 %) were prescribed insulin pumps, ‎with a mean age 13.72 ± 3.8 years, and 54.4% were males. Insulin pump use was 59% among non-Hispanic whites, 21.6% among Hispanics, 16.2% among African Americans, 23% among other racial and ethnic groups, 2.9% among Spanish-speaking patients, 20.9% among patients with Medicaid, and 52.8% among patients with private insurance. Data for baseline HbA1c and 6 months after initiation of insulin pump were available for 83 patients and showed a mean baseline HbA1c 7.98% and 6-month HbA1c 7.72% (P < 0.05). Median HbA1c in the most recent follow-up visit among insulin pump users was 7.8 % vs 9.4% (p < 0.001) among patients on multiple daily injections.  Conclusions: Results show a significant improvement in ‎hemoglobin A1c after starting an insulin pump, ‎indicating better glycemic control. Also, the data ‎demonstrate demographic disparities in insulin ‎pump use among pediatric patients with T1DM. ‎Data showed that insulin pump use was ‎significantly lower in racial/ethnic minorities, ‎Spanish-speaking patients, and in patients on public health insurance. Further research is ‎needed to identify and address barriers to ‎diabetes technology use.‎  Key messages: • Use of technology in pediatric diabetes.  • Technology and demographic disparity.
SN  - 1101-1262
SN  - 1464-360X
ER  -

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