Improved Glycemic Outcomes With Diabetes Technology Use Independent of Socioeconomic Status in Youth With Type 1 Diabetes
Published version of a preprint
Abstract
Objective Technology use in type 1 diabetes (T1D) is impacted by socioeconomic status (SES). This analysis explored relationships between SES, glycemic outcomes, and technology use. Research design and methods A cross-sectional analysis of HbA1c data from 2,822 Australian youth with T1D was undertaken. Residential postcodes were used to assign SES based on the Index of Relative Socio-Economic Disadvantage (IRSD). Linear regression models were used to evaluate associations among IRSD quintile, HbA1c, and management regimen. Results Insulin pump therapy, continuous glucose monitoring, and their concurrent use were associated with lower mean HbA1c across all IRSD quintiles (P Conclusions Technology use was associated with lower HbA1c across all socioeconomic backgrounds. Socioeconomic disadvantage does not preclude glycemic benefits of diabetes technologies, highlighting the need to remove barriers to technology access.
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A study among Australian youth with type 1 diabetes found no interaction between technology use and socio-economic disadvantage for HbA1c.
“Although we may have been underpowered for an interaction analysis, our findings are consistent with a study among Australian youth with type 1 diabetes, in which no interaction between technology use and socio‐economic disadvantage (measured using residential postcodes and the Index of Relative Socio‐Economic Disadvantage [IRSD]) was observed for HbA1c.”
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Khodabandehloo, P., Fakembe, P., Senga, J., Shulman, R., Lipscombe, L. L., Witteman, H. O., Banerjee, A., Presseau, J., Nakhla, M., Dogba, M. J., et al. (2025) · Diabetes, Obesity and Metabolism · doi:10.1111/dom.16426 · Cited by 6 · see citing works
“38 Health care providers may be less likely to recommend insulin pump therapy or AID to socially disadvantaged groups, fearing these groups may not use these devices safely and develop DKA.”
- Authors
- Lomax, K. E., Taplin, C. E., Abraham, M. B., Smith, G. J., Haynes, A., Zomer, E., Ellis, K. L., Clapin, H., Zoungas, S., Jenkins, A. J., Harrington, J., de Bock, M. I., Jones, T. W., Davis, E. A., Australasian Diabetes Data Network (ADDN) Study Group, Anderson, K., Andrikopoulos, S., Ambler, G., Barrett, H., Batch, J., Bergman, P., Cameron, F., Conwell, L., Cotterill, A., Cooper, C., Couper, J., Craig, M., Davis, E., de Bock, M., Fairchild, J., Fegan, G., Fourlanos, S., Glastras, S., Goss, P., Gray, L., Hamblin, P. S., Hofman, P., Holmes-Walker, D. J., Huynh, T., Isaacs, S., Jefferies, C., Johnson, S., Jones, T., Kao, J., King, B. R., Lafferty, A., Makin, J., Martin, M., McCrossin, R., Neville, K., Pascoe, M., Paul, R., Pawlak, D., Peña, A., Phillips, L., Price, D., Rodda, C., Simmons, D., Sinnott, R., Smart, C., Stell, A., Stone, M., Stranks, S., Tham, E., Waddell, B., Ward, G., Wheeler, B., Woodhead, H., & Zimmermann, A.
- Affiliations
- The Kids Research Institute Australia (AU)
- Monash University (AU)
- Princess Margaret Hospital for Children (AU)
- The University of Sydney (AU)
- Women's and Children's Health Network (AU)
- 10Department of Paediatrics, University of Otago, Christchurch, New Zealand
- 1Department of Endocrinology and Diabetes, Perth Children’s Hospital, Nedlands, Western Australia, Australia
- Corresponding author
- Lomax, Kate E.
- ORCID
- Lomax, Kate E.
- Taplin, Craig E.
- Abraham, Mary B.
- Smith, Grant J.
- Haynes, Aveni
- Zomer, Ella
- Ellis, Katrina L.
- Clapin, Helen
- Zoungas, Sophia
- Jenkins, Alicia J.
- Harrington, Jennifer
- de Bock, Martin I.
- Jones, Timothy W.
- Davis, Elizabeth A.
- Barrett, Helen
- Cameron, Fergus
- Conwell, Louise
- Couper, Jennifer
- Craig, Maria
- Fourlanos, Spiros
- Glastras, Sarah
- Hamblin, Peter Shane
- Hofman, Paul
- Huynh, Tony
- Isaacs, Sonia
- Jefferies, Craig
- Johnson, Stephanie
- King, Bruce R.
- Lafferty, Antony
- Paul, Ryan
- Peña, Alexia
- Phillips, Liza
- Rodda, Christine
- Simmons, David
- Sinnott, Richard
- Smart, Carmel
- Stell, Anthony
- Tham, Elaine
- Ward, Glenn
- Venue
- Diabetes Care
- Publisher
- American Diabetes Association
- Published
- 2024-02-07
- Volume
- 47
- Issue
- 4
- Pages
- 707-711
- ISSN
- 0149-5992 (ISSN-L)
- 1935-5548
- OpenAlex
- W4391593854
- Cited by
- 20
- References
- 0
- Citations by year
- 2026: 10 · 2025: 5 · 2024: 5
- FWCI
- 6.55
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Diabetes Care (publishedVersion)
- PubMed (publishedVersion)
- UWA Profiles and Research Repository (UWA) (submittedVersion)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Diabetes and associated disorders
- Keywords
- type 1 diabetes, youth, socioeconomic status, diabetes technology, glycemic control, HbA1c, insulin pump therapy, continuous glucose monitoring, diabetes technology access
- MeSH terms
- Adolescent, Australia, Blood Glucose, Cross-Sectional Studies, Diabetes Mellitus, Type 1, Glycated Hemoglobin, Humans, Social Class, Blood Glucose Self-Monitoring
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