{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T15:47:18Z","timestamp":1753890438021,"version":"3.41.2"},"reference-count":26,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,1,9]],"date-time":"2025-01-09T00:00:00Z","timestamp":1736380800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Clin. Diabetes Healthc."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>The UK National Paediatric Diabetes Audit (NPDA) data reports disparities in Haemoglobin A1c (HbA1c) levels among children and young people (CYP) with Type 1 Diabetes (T1D), with higher levels in those of Black ethnic background and lower socioeconomic status who have less access to technology. We investigate HbA1c differences in a T1D cohort with higher than national average technology uptake where &amp;gt; 60% come from an ethnic minority and\/or socioeconomically deprived population.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design &amp;amp; methods<\/jats:title><jats:p>Retrospective cross-sectional study investigating the influence of demographic factors, technology use, and socioeconomic status (SES) on glycaemic outcomes. The study population was 222 CYP with T1D who attended the diabetes clinic in 2022 at a single tertiary paediatric diabetes centre.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among 222 CYP, 60% were of ethnic minority (Asian, Black, Mixed and Other were 32%, 12%, 6% and 10% respectively) and 40% of white heritage. 94% used Continuous Glucose Monitoring (CGM) and 60% used Continuous Subcutaneous Insulin Infusion (CSII) via open or closed loop. 6% used Self-Monitoring of Blood Glucose (SMBG) and Multiple Daily Injections (MDI), 34% used CGM and MDI, 38% used CGM and CSII and 22% used Hybrid Closed-Loop (HCL) systems. Significant differences in HbA1c across therapy groups (p &amp;lt; 0.001) was noted with lowest HbA1c in HCL group (55 mmol\/mol; p &amp;lt;0.001). Despite adjusting for therapy type, the Black group had higher HbA1c than their white and Asian counterparts (p&amp;lt;0.001). CYP from the most deprived tertile had significantly higher HbA1c levels (p &amp;lt; 0.001) but the difference was not sustained after adjusting for therapy type.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Advanced diabetes technologies improve glycaemic control. Whilst equalising technology access mitigates socioeconomic disparities in HbA1c, CYP from Black ethnic background continue to display a higher HbA1c. The study underscores the necessity of fair technology distribution and further research into elevated HbA1c levels among Black CYP using advanced diabetes technology. <\/jats:p><\/jats:sec>","DOI":"10.3389\/fcdhc.2024.1417287","type":"journal-article","created":{"date-parts":[[2025,1,9]],"date-time":"2025-01-09T06:10:40Z","timestamp":1736403040000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Technology usage and glycaemic outcomes in a single tertiary centre with an ethnically diverse and socioeconomically deprived cohort of children with type 1 diabetes mellitus"],"prefix":"10.3389","volume":"5","author":[{"given":"India","family":"Dickinson","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ankita","family":"Gupta","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gar Mun","family":"Lau","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pranav Viswanath","family":"Iyer","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John Stuart","family":"Pemberton","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Suma","family":"Uday","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2025,1,9]]},"reference":[{"key":"B1","unstructured":"NPDA 2021-22 Report on care and outcomes\n          \n          2022"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-8587(22)00218-2","article-title":"Global incidence, prevalence, and mortality of type 1 diabetes in 2021 with projection to 2040: a modelling study","volume":"10","author":"Gregory","year":"2022","journal-title":"Lancet Diabetes Endocrinol"},{"key":"B3","doi-asserted-by":"publisher","first-page":"19322968231199113","DOI":"10.1177\/19322968231.","article-title":"Determination of glucose-independent racial disparity in hbA1c for youth with type 1 diabetes in the era of continuous glucose monitoring","author":"Christakis","year":"2023","journal-title":"J. Diabetes Sci. Technol"},{"key":"B4","doi-asserted-by":"publisher","first-page":"56","DOI":"10.2337\/dc22-1055","article-title":"Racial disparities in access and use of diabetes technology among adult patients with type 1 diabetes in a U.S","volume":"46","author":"Kanbour","year":"2023","journal-title":"Acad. Med. Center. Diabetes Care"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1007\/s00125-021-05397-4","article-title":"Realising the long-term promise of insulin therapy: the DCCT\/EDIC study","volume":"64","author":"Nathan","year":"2021","journal-title":"Diabetologia."},{"key":"B6","doi-asserted-by":"crossref","DOI":"10.4239\/wjd.v14.i8.1194","article-title":"Ten-year review of trends in children with type 1 diabetes in England and Wales","volume":"14","author":"Ng","year":"2023","journal-title":"World J. Diabetes."},{"key":"B7","doi-asserted-by":"crossref","first-page":"68","DOI":"10.2337\/cd22-0073","article-title":"Factors associated with achieving target A1C in children and adolescents with type 1 diabetes: findings from the T1D exchange quality improvement collaborative","volume":"41","author":"Demeterco-Berggren","year":"2022","journal-title":"Clin. Diabetes."},{"key":"B8","unstructured":"National Paediatric Diabetes Audit Report on Care and outcomes 2021\/22\n          \n          2023"},{"key":"B9","doi-asserted-by":"publisher","first-page":"7","DOI":"10.1007\/s40615-016-0335-8","article-title":"Racial\/ethnic disparities in diabetes quality of care: the role of healthcare access and socioeconomic status","volume":"5","author":"Canedo","year":"2018","journal-title":"J. Racial Ethn Health Disparities."},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.12788\/jhm.3664","article-title":"Socioeconomic and racial disparities in diabetic ketoacidosis admissions in youth with type 1 diabetes","volume":"16","author":"Maxwell","year":"2021","journal-title":"J. Hosp Med"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.2337\/dc18-0724","article-title":"Area deprivation and regional disparities in treatment and outcome quality of 29,284 pediatric patients with type 1 diabetes in Germany: A cross-sectional multicenter DPV analysis","volume":"41","author":"Auzanneau","year":"2018","journal-title":"Diabetes Care"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.3389\/fendo.2023.1191138","article-title":"Area deprivation and demographic factors associated with diabetes technology use in adults with type 1 diabetes in Germany","volume":"14","author":"Auzanneau","year":"2023","journal-title":"Front. Endocrinol. (Lausanne)"},{"key":"B13","unstructured":"A decade of disparities in diabetes technology use and hbA1c in pediatric type 1 diabetes: A transatlantic comparison\n          \n          \n            \n              Addala\n              A\n            \n            \n              Auzanneau\n              M\n            \n            \n              Miller\n              K\n            \n            \n              Maier\n              W\n            \n            \n              Foster\n              N\n            \n            \n              Kapellen\n              T\n            \n          \n          \n          2021"},{"volume-title":"English indices of deprivation 2019","year":"2019","key":"B14"},{"volume-title":"Education, england and wales","year":"2021","key":"B15"},{"volume-title":"DCA vantage\u00ae Analyzer","year":"2023","key":"B16"},{"key":"B17","doi-asserted-by":"crossref","first-page":"17","DOI":"10.3352\/jeehp.2021.18.17","article-title":"Sample size determination and power analysis using the G*Power software","volume":"18","author":"Kang","year":"2021","journal-title":"J. Educ. Eval. Health Prof."},{"key":"B18","unstructured":"Diabetes control is worse in children and young people with type 1 diabetes requiring interpreter support\n          \n          \n            \n              Idkowiak\n              J\n            \n            \n              Uday\n              S\n            \n            \n              Elhag\n              S\n            \n            \n              Barrett\n              T\n            \n            \n              Dias\n              R\n            \n            \n              Kershaw\n              M\n            \n          \n          \n          2023"},{"key":"B19","doi-asserted-by":"publisher","DOI":"10.1136\/bmjdrc-2021-002537","article-title":"Diabetes technologies for children and adolescents with type 1 diabetes are highly dependent on coverage and reimbursement: results from a worldwide survey","volume":"9","author":"Dos Santos","year":"2021","journal-title":"BMJ Open Diabetes Res. Care"},{"key":"B20","doi-asserted-by":"publisher","DOI":"10.1111\/pedi.13381","article-title":"An effective and cost-saving structured education program teaching dynamic glucose management strategies to a socio-economically deprived cohort with type 1 diabetes in a VIRTUAL setting","volume":"23","author":"Pemberton","year":"2022","journal-title":"Pediatr. Diabetes"},{"key":"B21","doi-asserted-by":"publisher","DOI":"10.2147\/DMSO.S416192","article-title":"Racial disparities in diabetes technology adoption and their association with hbA1c and diabetic ketoacidosis","volume":"16","author":"Conway","year":"2023","journal-title":"Diabetes Metab. Syndrome Obes"},{"key":"B22","doi-asserted-by":"publisher","DOI":"10.2337\/dci23-0057","article-title":"Making a good thing even better: expanding access and applicability of automated insulin delivery systems to benefit all youth with type 1 diabetes","volume":"46","author":"Addala","year":"2023","journal-title":"Diabetes Care"},{"journal-title":"NICE","article-title":"Technology appraisal guidance [TA943] Hybrid closed loop systems for managing blood glucose levels in type 1 diabetes","year":"","key":"B23"},{"key":"B24","doi-asserted-by":"publisher","DOI":"10.2337\/dc23-2033","article-title":"Improved glycemic outcomes with diabetes technology use independent of socioeconomic status in youth with type 1 diabetes","volume":"47","author":"Lomax","year":"2024","journal-title":"Diabetes Care"},{"key":"B25","doi-asserted-by":"publisher","DOI":"10.1111\/pedi.13155","article-title":"DYNAMIC: Dynamic glucose management strategies delivered through a structured education program improves time in range in a socioeconomically deprived cohort of children and young people with type 1 diabetes with a history of hypoglycemia","volume":"22","author":"Pemberton","year":"2021","journal-title":"Pediatr. Diabetes"},{"key":"B26","doi-asserted-by":"crossref","DOI":"10.1111\/pedi.13381","article-title":"An effective and cost-saving structured education program teaching dynamic glucose management strategies to a socio-economically deprived cohort with type 1 diabetes in a VIRTUAL setting","volume":"23","author":"Pemberton","year":"2022","journal-title":"Pediatr. Diabetes."}],"container-title":["Frontiers in Clinical Diabetes and Healthcare"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fcdhc.2024.1417287\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,1,9]],"date-time":"2025-01-09T06:10:45Z","timestamp":1736403045000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fcdhc.2024.1417287\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,1,9]]},"references-count":26,"alternative-id":["10.3389\/fcdhc.2024.1417287"],"URL":"https:\/\/doi.org\/10.3389\/fcdhc.2024.1417287","relation":{},"ISSN":["2673-6616"],"issn-type":[{"type":"electronic","value":"2673-6616"}],"subject":[],"published":{"date-parts":[[2025,1,9]]},"article-number":"1417287"}}