Loomba Lindsey, Bonanno Shaila, Arellano Diana, Crossen Stephanie, Glaser Nicole
Department of Pediatrics, University of California, Davis, Sacramento, CA, United States.
Department of Pediatrics, University of Washington, Seattle, WA, United States.
JMIR Diabetes. 2023 Jun 9;8:e45890. doi: 10.2196/45890.
Disparities in Insulin Pump Use Among Spanish-Speaking Children With Type 1 Diabetes Compared to Their Non-Hispanic White Peers: Mixed Methods Study.
We aimed to investigate the use of insulin pumps and continuous glucose monitoring (CGM) devices among Spanish-language-preferring children in our clinic population and to identify specific barriers to technology use.
First, we assessed rates and patterns of diabetes technology use (eg, insulin pumps and CGM devices) in a sample of 76 children (38 Spanish-language preferring and 38 non-Hispanic White). We compared rates of technology use, average length of time between diabetes diagnosis and initiation of insulin pump or CGM device, and rates of discontinuation of these devices between the Spanish-language-preferring and non-Hispanic White children. Second, to understand specific barriers to technology use, we compared responses to a questionnaire assessing decision-making about insulin pumps.
Spanish-language-preferring patients had lower rates of insulin pump use, even after controlling for age, gender, age at diagnosis, and type of health insurance. Spanish-language-preferring participants were more likely to report concerns over learning to use an insulin pump and were more likely to discontinue using an insulin pump after starting one.
These data confirm demographic disparities in insulin pump use among children with T1D and provide new insights about insulin pump discontinuation among Spanish-language-preferring children. Our findings suggest a need for improved patient education about insulin pump technology in general and improved support for Spanish-language-preferring families with T1D after initiation of pump therapy.
与非西班牙裔白人同龄人相比，讲西班牙语的1型糖尿病儿童在胰岛素泵使用方面的差异：混合方法研究。
我们旨在调查我们诊所中更喜欢使用西班牙语的儿童对胰岛素泵和持续葡萄糖监测（CGM）设备的使用情况，并确定技术使用的具体障碍。
首先，我们评估了76名儿童（38名更喜欢使用西班牙语的儿童和38名非西班牙裔白人儿童）样本中糖尿病技术的使用率和模式（例如胰岛素泵和CGM设备）。我们比较了更喜欢使用西班牙语的儿童和非西班牙裔白人儿童之间的技术使用率、糖尿病诊断与开始使用胰岛素泵或CGM设备之间的平均时间长度，以及这些设备的停用率。其次，为了了解技术使用的具体障碍，我们比较了一份评估胰岛素泵决策的问卷的回答。
即使在控制了年龄、性别、诊断年龄和健康保险类型之后，更喜欢使用西班牙语的患者胰岛素泵使用率较低。更喜欢使用西班牙语的参与者更有可能报告对学习使用胰岛素泵的担忧，并且在开始使用胰岛素泵后更有可能停止使用。
这些数据证实了1型糖尿病儿童在胰岛素泵使用方面的人口统计学差异，并为更喜欢使用西班牙语的儿童停用胰岛素泵提供了新的见解。我们的研究结果表明，总体上需要改善患者对胰岛素泵技术的教育，并在开始泵治疗后为患有1型糖尿病的更喜欢使用西班牙语的家庭提供更好的支持。
