1144-P: Racial/Ethnic Disparities in Accessing the Latest Automated Insulin Delivery (AID) System

Abstract

Background: AID systems improve glycemic control in youth with type 1 diabetes (T1D). There was a full market release of the OmniPod 5 (OP5) AID system in the United States on 8/1/2022 and it was FDA approved for ages ≥2 on 8/22/22. OP5 is available through pharmacy benefits and requires users to have a smartphone. We hypothesized that disparities exist in OP5 access. Methods: We assessed OP5 use at two pediatric diabetes centers among youth with T1D ages 2-21 who were using any version of an OmniPod (OP) insulin pump 3-months after the full market release. Differences in demographic characteristics of OP5 users compared to other OP pump users were assessed using Chi-squared and student’s independent two-sample t tests. Results: Of 1037 youth (mean age 12.8±4.4 years, 49.5% female, mean T1D duration 5.3±3.7 years), 510 (49.2%) were using OP5. Rates of OP5 use were higher among non-Hispanic White youth than among youth of all other racial/ethnic identities (53.2% vs 38.0%, p<0.0001). Youth using OP5 were more likely to be younger (12.3±4.0 years vs 13.2±4.7 years, p=0.0001) and to have a shorter T1D duration (4.9±3.5 vs 5.8±3.9 years, p=0.0002). There was a trend towards lower rates of uptake among publicly versus privately insured youth (43.1% vs 50.7%, p=0.054). There was no difference in OP5 use by sex (48.2% female vs 51.8% males, p=0.43). Conclusions: Minority youth were less likely to access the OP5 AID system 3-months after full-market release. Given the glycemic improvements associated with AID systems, it is important to promote equitable access to the latest diabetes technologies. Improving insurance coverage of technologies and supporting AID access without the need for a smartphone may support these goals. Disclosure B.E.Marks: Research Support; Tandem Diabetes Care, Inc., Dexcom, Inc., Medtronic. S.Meighan: Speaker's Bureau; Dexcom, Inc. E.A.Brown: None. A.Zehra: None. R.Suresh: None. J.L.Douvas: None. R.M.Wolf: Research Support; Dexcom, Inc., Boehringer Ingelheim Inc. Funding National Institutes of Health (K23DK129827)