Using technology to address disparities and promote healthcare equity in Type 1 Diabetes (EquiT1D) A nonrandomized clinical trial investigating solutions to low technology use
Abstract
Although diabetic ketoacidosis (DKA) is more frequent among racial and ethnic minority populations, continuous glucose monitoring (CGM) use is lower in such groups. We sought to determine if care navigation support increases CGM utilization in patients with recurrent admissions for DKA. Using Technology to Address Disparities and Promote Healthcare Equity in Type 1 Diabetes (EquiT1D) is a prospective, single-arm study conducted at an academic medical center. Adult patients with type 1 diabetes (T1D) at high risk for DKA were recruited for participation. From November 2020 to April 2022, patients were consented to participate in an intervention which involved regular contact and care navigation to address barriers to CGM utilization. The primary study outcome was CGM utilization (percentage of days with sensor data). At 12 months, navigation support was associated with an increase in model-estimated mean (SE) CGM utilization from 17.5% (6.8%) at baseline to 51.4% (6.9%) at 12 months (P < 0.001). This study suggests that navigation support may be an effective way to increase CGM utilization among patients at high risk for DKA recurrence. Additional studies are needed to address barriers to CGM utilization. Trial Registration:clinicaltrials.gov, NCT06899984 (https://clinicaltrials.gov/study/NCT06899984?term=equit1d&rank=1#study-overview).
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Evidence Hub reads this as a randomized trial, done in people. Its evidence level is 2 of 5 (High · randomized trial). Randomized trials of a reasonable size are the strongest single-study design.
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