A population-based US study finds greater technology use and improved glycemic control but a low prevalence of an A1c level | 7% and widening disparities.
These findings came from an analysis of national electronic health record s of nearly 200,000 children and adults with T1D by Michael Fang, PhD, of the Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, and colleagues. The study wasUse of continuous glucose monitors increased substantially from 2009-2011 to 2021-2023, from less than 5% in both children and adults to more than 80% and over half, respectively.
Asked to comment, Anne L. Peters, MD, professor of clinical medicine and director of Clinical Diabetes Programs at the Keck School of Medicine of USC, Los Angeles, toldthat a key component is having staff to help with prior authorization paperwork and certified diabetes care and education specialists to help train patients and troubleshoot. “These health disparities are real but fixable. However, it takes staff to make it happen.
Among youths, the prevalence of achieving glycemic control, defined as an A1c level < 7%, rose from about 7% in 2009-2011 and 2014-2017 to 19% in 2021-2023 . Glycemic control improved for all youth subgroups except for Black youths. Differences by race, ethnicity, and insurance type increased after 2018-2020.
Peters has one practice in the relatively wealthy west side of Los Angeles and another in an underserved area in East Los Angeles. On the west side, she has a full-time staffer who exclusively handles prior authorizations for diabetes devices and a CDCES who trains patients and follows them weekly. The patients there all speak English and have high health literacy.
Diabetes Mellitus Type I Type 1 Diabetes Type 1 DM T1DM T1D Type 1 Diabetes Mellitus Type 1 Diabetes Mellitus (T1DM) Type 1 Diabetes (T1D) Revenue And Practice Management Practice Management Revenue Insurance Health Insurance Electronic Health Record EHR Electronic Health Record (EHR) Social Determinants Of Health SDOH Social Determinants Of Health (SDOH)
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