1083-P: Barriers to Insulin Pump Use in Adults with Type 1 Diabetes

Introduction: Hybrid closed loop systems (HCL) reduce hypoglycemia and increase time in range in adults with type 1 diabetes (T1D). In Sept. 2023, 62.9% of our T1D adults were using insulin pumps, of which a majority were using HCL. Objective: To understand current barriers for insulin pump use in T1D adults. Methods: A survey was sent electronically, in Oct. 2023, to T1D adults ages ≥ 22 yrs, with ≥ 1 visit, in-person or virtual, from 9/1/2022 - 9/1/2023 with an email address (n=1517). Results: The overall response rate was 22.9% [263 pump users responded, response rate 29.9%; 85 non-pump users responded, response rate 13.3%). Median age of respondents vs non-respondents was 54 years (range 22 -94) vs. 40 years (22 yrs-100). 60.9% of respondents were female vs. 47.5% of non-respondents. Respondents/non-respondents were 94%/88.2% non-Hispanic white (n=328/1031), 2.6%/6.2% non-Hispanic Black (n=9/72) and 1.1%/2.4% Hispanic (n=4/28). 59.2% of respondents had private insurance, 39.1% public insurance. CGM was used by more pump users (n=879; 91.9%) vs non-pump users (n=638; 79.3%). Median A1c of respondents was 7.0% (CGM use 89.1%), vs non-respondents median A1c 7.8% (CGM use 85.5%). Survey results are shown in table below. Limitations: Low response rate and low diversity Conclusion: More education, including addressing beliefs and understanding potential benefits of insulin pump therapy, is needed for the ~1/3 of T1D adults not currently using a pump. Disclosure J. Erardi: None. A.D. Lora Matos: None. B.A. Wells: None. J.L. Romeiser: None. J. Owusu-Barnie: None. R.S. Weinstock: Research Support; Eli Lilly and Company, Tandem Diabetes Care, Inc., Diasome, Amgen Inc., MannKind Corporation, Insulet Corporation, Novo Nordisk. Other Relationship; Dexcom, Inc.