Reducing Inequity in Type 1 Diabetes Care

Reducing Inequity in Type 1 Diabetes Care

Young adults from underrepresented minority groups (YA-URMs) with type 1 diabetes (T1D) are a fast-growing segment of T1D patients in the United States. Compared with their white peers, however, YA-URMs face a greater risk for worse outcomes including poorer glycemic control. Research suggests a possible reason: YA-URMs’ lack access to diabetes technologies (insulin pump therapy and continuous glucose monitors, for example), which represent a potential intervention target for providing better care.

Shivani Agarwal, M.D., has received a three-year, $1 million National Institutes of Health grant to assess an enhanced community health worker program that encourages and supports the use of diabetes technologies among YA-URMs. Thanks to their unique position between communities and health systems, community health workers can advocate for underserved patients while also providing extra support for providers in a cost-effective manner. During a six-month trial, YA-URMs will be randomized to the community health worker model or to usual care. This pilot project will determine whether community health workers can increase technology use among YA-URMs by becoming part of the T1D team-based care approach. The trial’s results may help to reduce disparities in the treatment provided to YA-URMs.

Dr. Agarwal is an assistant professor of medicine at Einstein and an attending physician at Montefiore Health System. (1R01DK132302-01)

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