What does this research mean for the field?

A structured quality improvement approach utilizing tailored interventions increases the equitable adoption of diabetes technologies, including continuous glucose monitors, insulin pumps, and connected insulin pens, across diverse racial and ethnic groups. Novelty: ClaimNovelty.CONFIRMATORY. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

This project aims to address inequities in diabetes technology use among different racial and ethnic groups.

June 7, 2026

1911-P: Advancing Equity in Diabetes Technology: Type 1 Diabetes Exchange QI Collaborative Multicenter Quality Improvement Project across Adult and Pediatric Centers

Key Points

This project aims to address inequities in diabetes technology use among different racial and ethnic groups.
Nine centers participated in a multicenter quality improvement project.
Interventions included chart reviews, bias training for clinicians, and disparities questionnaires to identify barriers.
Sites implemented a health equity framework utilizing Plan-Do-Study-Act (PDSA) cycles.
Seven of 9 centers increased CGM and pump usage across all racial/ethnic groups.
Two of 3 centers increased connected insulin pen use.
Five of 9 centers reduced the equity gap in CGM and pump use between Non-Hispanic White and Non-Hispanic Black populations.

Abstract

Introduction and Objective: Despite evidence that diabetes technologies improve glycemic outcomes, inequities in device use persist across racial and ethnic groups. Building on a prior pilot, the T1D Exchange Quality Improvement Collaborative (T1DX-QI) launched an equity expansion project to validate interventions, promote sustainability, and broaden the scope to include connected insulin pens (CIPs) in addition to CGM and insulin pumps. Project aims to increase equitable use of CGM, insulin pumps and CIPs. Methods: Nine centers participated in the multicenter project. Participating centers utilized the T1DX-QI heath equity framework. Sites applied tools including process maps, fishbone diagrams, and Plan-Do-Study-Act (PDSA) cycles to test interventions locally. Sample interventions included chart reviews to facilitate shared decision making, use of disparities questionnaires to identify and address barriers, in-clinic interpreter support, early education at diagnosis, bias training for clinicians, streamlined device prescription processes, patient and provider education, and assistance to reduce out-of-pocket cost. All nine centers implemented interventions to increase CGM and insulin pump use while three centers tested interventions to increase CIP use. Results: Seven of 9 centers achieved higher CGM and pump use across all racial/ethnic groups. Two of 3 centers increased CIPs use. Five out of 9 centers reduced the equity gap in CGM and pump use between Non-Hispanic White (NHW) and Non-Hispanic Black and between NHW and Hispanic populations. Conclusion: This multi-center equity project demonstrated that a structured QI approach can advance equity in diabetes technology use. Tailored interventions improved CGM, pump, and CIP adoption across racial and ethnic groups Disclosure O. Odugbesan: None. N. Rioles: None. T. Wright: None. T.R. Bol: None. G. Davis: Research Support; Current; Insulet Corporation, Sequel Med Tech. C. Demeterco-Berggren: Advisory Panel; Ended; Sanofi. Board Member; Current; Glooko, Inc. Research Support; Ended; Medtronic. E. Edmondson: Research Support; Current; American Diabetes Association. H.K. Akturk: Consultant; Current; Roche, Medtronic, Dexcom, Inc. Research Support; Current; Roche, Abbott. S. Ogburn: None. C.A. Williams: None. F. Vendrame: None.

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