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Health Equity Advancement Lab

Purpose/Background:

Approximately 1.6 million people in the United States have type 1 diabetesi. The incidence of type 1 diabetes is increasing in the United States across all populations, most significantly among Hispanic youth. Numerous type 1 diabetes-related health inequities exist across racial and ethnic groups. Compared to non-Hispanic White people with diabetes:

  • Hispanic and non-Hispanic Black people with type 1 diabetes have higher A1c levels;
  • Non-Hispanic Black people with type 1 diabetes are 2.5 times more likely to have one or more DKA episodes and 2.5 times more likely to have had one or more severe hypoglycemic even in the previous 12 months;
  • Non-Hispanic Black people with type 1 diabetes have twice the mortality rate.

T1Dx data reveals inequities exist in diabetes technology useii, and the COVID-19 pandemic has further exposed the inequitable burden of diseaseiii,iv.

The T1Dx strives to reduce health inequities among people with diabetes. Recent strategies include adapting quality improvement tools and principles into a frameworkv for advancing health equity and partnering with industry partners on a quality improvement pilotvi. The HEAL Advisory Group will reinforce T1Dx efforts to reduce health equities among the T1D population.

Vision:

To achieve equity for patients with type 1 diabetes by piloting innovative approaches in the T1D Exchange Quality Improvement Collaborative
 

HEAL Objectives:

The T1Dx HEAL Program is a network of health equity clinical and research leaders aiming to provide thought leadership around the T1Dx health equity initiatives. The HEAL Program will contribute to best practices regarding equitable type 1 diabetes care through multiple strategies, including but not limited to:

  • Revising or developing new measures for health equity
  • Providing advice and feedback on grants
  • Piloting new health equity initiatives
  • Applying evaluation rigors to make recommendations on equitable policies
  • Sharing learning and best practices nationally

HEAL Advisory Group members can find additional information in the T1Dx “Breaking Down the Science” seriesvii.

References:

i Centers for Disease Control and Prevention. National Diabetes Statistics Report, 2020. Atlanta, GA: Centers for Disease Control and Prevention, U.S. Dept of Health and Human Services; 2020.
ii Shideh Majidi, Ebekozien Osagie et al Inequities in Health Outcomes among Children and Adults with Type 1 Diabetes: Data from the in T1Dx QI Collaborative https://clinical.diabetesjournals.org/content/early/2021/06/03/cd21-0028
iii Osagie Ebekozien, Shivani Agarwal et al Inequities in Diabetic Ketoacidosis among Patients with Type 1 diabetes and COVID-19: Data from 52 US Clinical Centers. Journal of Clinical Endocrinology and Metabolism December 2020 10.1210/clinem/dgaa920
iv Nudrat Noor, Ebekozien O Diabetes Technology Use for management of type 1 diabetes (T1D) is associated with fewer adverse COVID-19 outcomes: Findings from the T1D Exchange COVID-19 Surveillance Registry. Diabetes Care 2021 https://doi.org/10.2337/dc21-0074
v Ebekozien OA, Ori Odugbesan et al Equitable Post COVID-19 Care: A Practical Framework to integrate Health Equity in Diabetes Management. Journal of Clinical Outcomes and Management Nov 2020 https://doi.org/10.12788/jcom.0031
vi Medtronic. (2021, April 7). Medtronic Announces Ongoing Initiatives to Address Health Equity for People of Color Living with Diabetes. [Press release]. Retrieved from https://news.medtronic.com/2021-04-07-Medtronic-Announces-Ongoing- Initiatives-to-Address-Health-Equity-for-People-of-Color-Living-with-Diabetes
vii https://t1dexchange.org/the-t1d-exchange-health-equity-advancement-lab-program/

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