The T1D Exchange technology equity improvement project: Baseline analysis of insulin pump use

Background: The T1D Exchange Quality Improvement Collaborative (T1Dx-QI) is a learning network of 41 US type 1 diabetes clinics. Multiple studies have demonstrated lower rates of insulin pump use in Non-Hispanic Black (NHB) and Hispanic patients with Type 1 diabetes (T1D). As part of an ongoing multi-level intervention to improve insulin pump equity, we aimed to analyze baseline insulin pump rates among participating sites.

Method: T1Dx-QI identified six diabetes centers from the learning network to pilot an equity-focused Quality Improvement intervention to address disparities in insulin pump use among NHB and Hispanic compared to Non-Hispanic White (NHW) patients. Aggregate data from the Electronic Medical Record was reported from November 2020 to June 2021. The data were stratified by race and ethnicity. Median insulin pump use was calculated using Lahey P run charts and data was analyzed and plotted on a trend chart.

Result: The baseline data from participating clinics show a stable trend (P-value .2). The median insulin pump use was 45% in NHW patients, 17% in NHB patients, and 26% in Hispanic patients. The difference in medians between NHW and NHB patients was 28% and the difference between NHW and Hispanic patients was 19% (Figure 1).

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