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(Sacramento)
Many children with type 1 diabetes take advantage of technology — including insulin pumps and continuous glucose monitors (CGM) — to help manage blood sugar, which is key to staying healthy.
But a new study from the University of California, Davis, found that if children with type 1 diabetes come from predominantly Spanish-speaking families, they are less likely than other children to use insulin pumps and continuous glucose monitors. The findings, recently published in JMIR Diabetes, confirm previous research that found Spanish-speaking patients with type 1 diabetes are more likely to face barriers to using this technology.
The study also indicated that Spanish-speaking families:
- They tend to discontinue insulin pump use at higher rates than their counterparts from primarily English-speaking families.
- They are more likely to have problems learning to use insulin pumps.
“This is the first study to show higher rates of insulin pump discontinuation among Spanish-speaking children,” said Lindsay Lomba, a pediatric endocrinologist at UC Davis Children’s Hospital and first author. “This study also confirmed known disparities in the use of diabetes technology among children with diabetes.” “With diabetes.” the study. “It highlights the need to improve Spanish language education about insulin pumps and increase support for families after adopting pump technology.”
Rates of insulin pump use and continuous glucose monitor use decline, with many people discontinuing their use
This study measured rates and patterns of insulin pump and continuous glucose monitoring device use among Spanish-speaking children with type 1 diabetes to identify specific barriers to technology use.
The study examined 76 children (38 from Spanish-speaking homes and 38 from English-speaking homes) with type 1 diabetes. Participants were between 0 and 18 years of age and had received care at a diabetes clinic in the past 12 months. Spanish-speaking children identified Spanish as their family’s primary language, while English-speaking children identified English as their family’s primary language. Patients were enrolled in the study over a period of six months.
The study found that only 34% of Spanish-speaking participants used insulin pumps, compared to 63% of their English-speaking counterparts. CGM devices were used by 50% of Spanish-speaking participants versus 79% of their non-Hispanic white counterparts.
Among the group that used insulin pumps, Spanish-speaking participants began use at about the same time after diagnosis as English-speaking participants. However, Spanish-speaking participants began using a CGM device later.
Overall, families with government-sponsored insurance were significantly less likely to use a CGM, but there was no difference in insulin pump use by health insurance type.
Among the Spanish-speaking participants, 19 of 38 were non-current pump users. Thirteen of the 38 had never used an insulin pump before.
Breaking down barriers to encourage the use of technology
To better understand specific barriers to technology use, Spanish-speaking study participants and their families were asked to complete a questionnaire written in Spanish, detailing their technology use.
The results revealed that Spanish-speaking patients were more likely to report previously using an insulin pump, but had stopped using it because they didn’t like the technology (a staggering 32%, compared to 0% for English-speaking patients). Spanish-speaking patients were also more likely to express concern about cost, compared to non-Hispanic white participants. They were also less likely to report confidence in learning to use the device.
“This is important information because it indicates the need for better support for our Spanish-speaking patients after starting insulin pump therapy,” Lomba said. “Our team is working to improve educational processes as a result of this study.”
The study also indicates that Spanish-speaking families can benefit from instructions and educational materials in their native language, as well as increased connection with peer groups using diabetes technology.
Study co-author Stephanie Crossen is taking the lead in helping Spanish-speaking families by participating in a multi-site collaboration called Improving Diabetes Technology Use for Latino Youth through DREAM (Reimagining Device Use through Education and Mentoring) groups, Lomba said. Virtual Peers.”
“This project will help guide future education and support efforts,” Lomba said. “We will continue to work to achieve these goals to support our patients.”
Other study authors include Shayla Bonanno, of the University of Washington, Seattle; Diana Arellano, of UCSF Benioff Children’s Hospital; and Nicole Glaser, of UC Davis Health.
This study was funded by a grant from the Children’s Miracle Network at UC Davis.
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