Insulin Pump Use in Young Children with Type 1 Diabetes: Sociodemographic Factors and Parent-Reported Barriers

Abstract

These findings provide an opportunity to address potentially modifiable parent-reported barriers to pump uptake through education and behavioral intervention.

ISPAD Clinical Practice Consensus Guidelines 2018: Diabetes technologies

“…In the PDC study, pump therapy was more common in those with private health insurance, non‐Hispanic white race, annual family income over $100 000, and a parent with a college education . A more recent analysis has echoed these findings showing sociodemographic factors, namely, income and parental education, increased frequency of blood glucose monitoring, and CGM use were predictive of pump use . The authors also highlight potential barriers to uptake of the technology, which include concerns regarding the physical footprint and interference of the device, therapeutic effectiveness of the technology, and to a lesser extent, financial burdens this mode of insulin delivery may cause .…”

“…64 A more recent analysis has echoed these findings showing sociodemographic factors, namely, income and parental education, increased frequency of blood glucose monitoring, and CGM use were predictive of pump use. 65 The authors also highlight potential barriers to uptake of the technology, which include concerns regarding the physical footprint and interference of the device, therapeutic effectiveness of the technology, and to a lesser extent, financial burdens this mode of insulin delivery may cause. 65 In some countries, non-coverage of pump therapy by the health care/insurance system likely influences the low adoption rates of this…”

“…65 The authors also highlight potential barriers to uptake of the technology, which include concerns regarding the physical footprint and interference of the device, therapeutic effectiveness of the technology, and to a lesser extent, financial burdens this mode of insulin delivery may cause. 65 In some countries, non-coverage of pump therapy by the health care/insurance system likely influences the low adoption rates of this…”

Continuous subcutaneous insulin infusion versus multiple daily injections for type 1 diabetes

“…In Australia, insulin pumps are not provided through Medicare or hospitals and, in the absence of private health insurance, are unaffordable to many unless these families are able to access the limited income‐tested government funding or philanthropic donations. Financial constraints, education level and ability to cope with diabetes management are some of the common barriers to insulin pump therapy and must be considered …”

“…Financial constraints, education level and ability to cope with diabetes management are some of the common barriers to insulin pump therapy and must be considered. 20 Clinical Bottom Line T1DM is a confronting and intense disease that requires patient and care giver commitment to reduce short-and long-term complications. It is important to explain to patients and their families the importance and rationale behind aiming for optimal glycaemic control and the risks associated with poor glycaemic control.…”