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Inequities in health care delivery and outcomes continue to exist in the field of medicine, despite increased awareness of racial and ethnic inequities. To inform future research on the barriers to care and potential interventions to improve diabetes care for individuals from all backgrounds, it is important to use large cohorts to identify these disparities. T1D Exchange QI (T1DX-QI) is a population-based cohort with twelve national clinics engaged in data sharing and quality improvement (QI) methods to drive system changes. Over 22,000 pediatric and adult patient demographic and diabetes characteristics data were combined and analyzed from seven T1DX-QI clinics. Characteristics of the patient population are available in Table 1. The cohort included 75% non-Hispanic White (NHW), 7% non-Hispanic Black (NHB), 3% Hispanic and 15% Other. Mean A1C was highest in NHB (9.9%) and Hispanic (9.3%; p<0.001) participants. Insulin pump and continuous glucose monitor use was lowest in NHB participants (p<0.001). The T1DX-QI cohort is the largest population to date available to investigate health inequities in T1D. Differences in A1C and technology use still persist, particularly in the NHB population. These results highlight the critical need to study barriers to care in individuals from various backgrounds in order to provide adequate and optimal care to everyone with T1D.
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Inequities in Health Outcomes among Patients in the T1DX-QI Collaborative.
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