RECRUITING

Breaking Disparities in Access to Advanced Diabetes Technologies in Children With Type 1 Diabetes

Description

50 children/adolescents (ages 6 to \<18yrs) with T1D in suboptimal control (HbA1c≥8.0%) and lower SES (below 200% poverty line) on insulin therapy (either injections or open-loop pumps) will be recruited at Nemours \~ 1/3 each AA, Hispanic/Latino, non-Hispanic whites. All families that qualify and agree to transition to closed-loop technologies will be recruited to allow data to be gathered before and after use of devices. They will go through the process of approval with the assistance of an insurance navigator in clinic. Those not a CGM will be prescribed one as well. Diabetes care will be 'real life', devices will be prescribed, and care per clinic routine with periodic device downloads. Principal outcome, time-in-range, will be analyzed at 3-months compared to baseline, each participant their own control. Secondary outcomes including HbA1c, other glucose metrics and questionnaires related to use of technology and diabetes distress will be also analyzed. All outcomes will also be collected at 6-months. Results could have important and fast applicability to the field and help better inform decision makers, including payers, clinicians, and patients and families and could serve to decrease health care disparities in this needy population.

Study Overview

Study Details

Study overview

50 children/adolescents (ages 6 to \<18yrs) with T1D in suboptimal control (HbA1c≥8.0%) and lower SES (below 200% poverty line) on insulin therapy (either injections or open-loop pumps) will be recruited at Nemours \~ 1/3 each AA, Hispanic/Latino, non-Hispanic whites. All families that qualify and agree to transition to closed-loop technologies will be recruited to allow data to be gathered before and after use of devices. They will go through the process of approval with the assistance of an insurance navigator in clinic. Those not a CGM will be prescribed one as well. Diabetes care will be 'real life', devices will be prescribed, and care per clinic routine with periodic device downloads. Principal outcome, time-in-range, will be analyzed at 3-months compared to baseline, each participant their own control. Secondary outcomes including HbA1c, other glucose metrics and questionnaires related to use of technology and diabetes distress will be also analyzed. All outcomes will also be collected at 6-months. Results could have important and fast applicability to the field and help better inform decision makers, including payers, clinicians, and patients and families and could serve to decrease health care disparities in this needy population.

Breaking Health Care Disparities in Access to Advanced Diabetes Technologies in Children With Type 1 Diabetes

Breaking Disparities in Access to Advanced Diabetes Technologies in Children With Type 1 Diabetes

Condition
Diabetes Mellitus, Type 1
Intervention / Treatment

-

Contacts and Locations

Jacksonville

Nemours Children's Health, Jacksonville, Florida, United States, 32207

Orlando

Nemours Children's Health, Orlando, Florida, United States, 32827

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

For general information about clinical research, read Learn About Studies.

Eligibility Criteria

  • * HbA1C ≥ 8.0% at least twice within the last 12 months before study initiation, upper limit of HbA1C \<14%
  • * Be of lower SES, defined based on \< 200% above published US levels of poverty by family size and income, or based on exceptional circumstantial needs in the opinion of the investigators
  • * Approximately 1/3 AA, 1/3 Hispanic/Latinos, 1/3 non-Hispanic whites. Asians, Pacific Islanders and other ethnic groups however will not be excluded from participation if other criteria met
  • * History of hypothyroidism on adequate replacement therapy with normal thyroid function will be allowed
  • * Severe eczema or any other skin condition that would limit availability of healthy skin to wear devices
  • * Chronic medications/medical conditions that could interfere with diabetes management (ADHD medications allowed)
  • * Chronic seizures, or severe neurodevelopmental delay
  • * Current use of hybrid closed-loop, automated insulin delivery system
  • * Significant mental health disorder that in opinion of the investigator would hinder device use

Ages Eligible for Study

6 Years to 17 Years

Sexes Eligible for Study

ALL

Accepts Healthy Volunteers

No

Collaborators and Investigators

Nemours Children's Clinic,

Nelly Mauras, MD, PRINCIPAL_INVESTIGATOR, Nemours Children's Health Jacksonville

Study Record Dates

2025-05