What question did this study set out to answer?

This analysis aims to assess differences in health insurance literacy between emerging adults with type 1 diabetes receiving pediatric versus adult specialty care.

June 7, 2026

1603-P: Health Insurance Literacy by Type 1 Diabetes Care Setting: Pediatric vs. Adult Care

Key Points

This analysis aims to assess differences in health insurance literacy between emerging adults with type 1 diabetes receiving pediatric versus adult specialty care.
Recruitment of 192 emerging adults with type 1 diabetes across the US using iHERO RCT.
Measurement of health insurance literacy using Health Insurance Literacy Measure and KAT-1 Insurance Knowledge Subscale.
Comparison of baseline health insurance literacy between pediatric (n=52) and adult (n=119) groups.
Adult diabetes care group had higher KAT-1 insurance knowledge scores (median [IQR]: 8 [6-8] vs 6 [5-7]; p < .001).
Both groups exhibited low overall health insurance literacy.
Demographic differences noted in the pediatric care group included younger age and greater likelihood of being insured through parents.

Abstract

Introduction and Objective: Health insurance literacy (HIL) is the ability to understand and use health insurance to best meet care needs. Emerging adults (EA) 18-30 yrs old, with type 1 diabetes (T1D), often face financial instability and low HIL. The objective of this analysis was to assess differences in HIL between EA receiving pediatric versus adult diabetes specialty care. Methods: The iHERO RCT recruited 192 EA with T1D across the US from clinics and online to test a community-developed HIL Toolkit. HIL was measured by Health Insurance Literacy Measure (HILM) and KAT-1 Insurance Knowledge Subscale. Baseline HIL was compared between pediatric (n=52) and adult (n=119) diabetes specialty care (N=171 for analysis). Cases without specialty care (n=9) or with missing provider type (n=1) were excluded. Results: The pediatric care group had age-related demographic differences (younger age, greater likelihood of being a student and having parents’ insurance), but otherwise had characteristics similar to the adult group (Table 1). KAT-1 insurance knowledge scores were higher in the adult vs pediatric group (median IQR: 8 6-8 vs 6 5-7; Kruskal-Wallis χ²(1) = 13.33, p .001). Conclusion: Although those in adult diabetes care demonstrated greater insurance knowledge than those in pediatric care, HIL was low in both groups, underscoring the need for targeted education for EA with T1D. Upon completion of the RCT, it will be critical to evaluate the relative impact of the Toolkit on HIL within these two groups. Disclosure T. Calvache: None. C. Corum: None. P. Ramkumar: None. C. Lewis: Consultant; Current; Dexcom, Inc. E.L. Lundgrin: None. J. Blanchette: Advisory Panel; Ended; Eli Lilly and Company. Advisory Panel; Current; MannKind Corporation. Research Support; Current; Leona M. and Harry B. Helmsley Charitable Trust, American Heart Association. Speaker's Bureau; Current; Insulet Corporation. Consultant; Current; Sequel MedTech. Consultant; Ended; Embecta. Research Support; Current; National Institute of Diabetes and Digestive and Kidney Diseases. Funding Leona M. and Harry B. Helmsley Charitable Trust (G-2305-05992)

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