The impact of insurance coverage and the family on pediatric diabetes management

Abstract

Insurance type and family composition have significant associative effects on glycemic control and insulin management that may be mitigated by insulin pump therapy. Identifying and addressing factors such as availability of resources, family education, and adult support and supervision, may help improve glycemic control in high-risk pediatric diabetes patients.

Risk of Microvascular Complications and Macrovascular Risk Factors in Early-Onset Type 1 Diabetes after at Least 10 Years Duration: An Analysis of Three Population-Based Cross-Sectional Surveys in Germany between 2009 and 2016

“…With regard to the family and socioeconomic background, we found that not living with both biological parents increased the risk slightly. This is consistent with other studies that identified an association between family structure and glycemic control [ 12 ]. In addition, associations between SES [ 31 ] have been documented previously.…”

“…Since the DCCT trial, the central aim of near-normal glycemic control is well established to avoid diabetes-related late complications and comorbidity [ 11 ]. Besides that, social, lifestyle-related, and health care-related factors have been associated with the risk of complications and/or CVD risk factors [ 12 ]. In turn, glycemic control has been related to psychosocial and family background in children and adolescents [ 12 , 13 ].…”

“…Besides that, social, lifestyle-related, and health care-related factors have been associated with the risk of complications and/or CVD risk factors [ 12 ]. In turn, glycemic control has been related to psychosocial and family background in children and adolescents [ 12 , 13 ].…”

Diabetes technologies for children and adolescents with type 1 diabetes are highly dependent on coverage and reimbursement: results from a worldwide survey

“…Although 95% of HCPs have insulin pumps and CGM systems available at their practice setting, the lack of coverage for them is an immediate explanation for the weak uptake. Countries with universal healthcare and wider availability of diabetes technologies, along with insurance-based countries with coverage for diabetes technologies are more likely to have a higher proportion of people with diabetes using technology, whereas most developing countries, despite holding universal healthcare, do not finance the newest diabetes delivery devices and make access to diabetes technology more limited 14 15 25 26. However, after cost and economic concerns, the most common reason to turn down technology has been pointed out to be wear-related issues, in line with what was found in our survey 21…”

Social determinants of health and primary immunodeficiency

“…Although data regarding the impact of socioeconomic and insurance status on the management and prognosis of patients with IEI are lacking, multiple studies have alluded to gaps in unmet health care needs 99,100 and the management and outcome of various conditions. [100][101][102][103][104] The reasons for these disparities are difficult to dissect but are presumably multifaceted, including delays in diagnosis and treatment 101 and an association of less favorable insurance status with household poverty. In the United States, the Patient Protection and Affordable Act of 2010 has allowed for 20 million previously uninsured adults to gain health care insurance coverage, reducing delays in necessary medical care and increasing outpatient visits, access to preventative medical services, 105,106 and patient-reported health.…”