Fleischer Institute for Diabetes and Metabolism, Albert Einstein College of Medicine-Montefiore Medical Center, Bronx, NY, USA.
NY Regional Center for Diabetes Translational Research, Albert Einstein College of Medicine, Bronx, NY, USA.
Curr Diab Rep. 2022 Jul;22(7):275-281. doi: 10.1007/s11892-022-01470-3. Epub 2022 Jun 1.
The management of diabetes has been revolutionized by the introduction of novel technological treatments and modalities of care, such as continuous glucose monitoring, insulin pump therapy, and telehealth. While these technologies have demonstrated improvement in health outcomes, it remains unclear whether they have reduced inequities from racial/ethnic minority or socioeconomic status. We review the current literature to discuss evidence of benefit, current limitations, and future opportunities of diabetes technologies.
While there is ample evidence of the health and psychological benefit of diabetes technologies in large populations of people with type 1 and type 2 diabetes, there remain wide disparities in the use of diabetes technologies, which may be perpetuating or widening inequities. Multilevel barriers include inequitable prescribing practices, lack of support for social determinants of health, mismatch of patient preferences and care models, and cost. We provide a review of disparities in diabetes technology use, possible root causes of continued inequity in outcomes, and insight into ways to overcome remaining gaps.
目的综述：新型技术治疗和护理方式（如连续血糖监测、胰岛素泵治疗和远程医疗）的出现彻底改变了糖尿病的治疗模式。虽然这些技术已证明能改善健康结局，但尚不清楚它们是否减少了来自种族/民族或社会经济地位的不平等。我们回顾了现有文献，讨论了糖尿病技术的获益证据、当前局限性和未来机遇。
发现：虽然有大量证据表明 1 型和 2 型糖尿病患者群体中糖尿病技术在健康和心理方面具有获益，但糖尿病技术的使用仍存在很大差异，这可能导致或扩大不平等。多层次障碍包括处方实践的不平等、缺乏对健康社会决定因素的支持、患者偏好与护理模式不匹配以及费用问题。我们对糖尿病技术使用方面的差异进行了综述，探讨了导致结果持续不平等的可能根本原因，并深入了解克服剩余差距的方法。
