Gap in diabetes technology use among Black and white Medicare beneficiaries widens: study

Black Medicare beneficiaries use insulin pumps and continuous glucose monitors (CGMs) less than white beneficiaries, and the gap is widening, according to the Endocrine Society.

In a news release, the Society says a new study published in its Journal of Clinical Endocrinology & Metabolism finds that the prevalence of insulin pump use for Black beneficiaries with Type 1 diabetes increased from 3.9% to 4.6% between 2017 and 2019. But use of insulin pumps among white beneficiaries increased from 14% to 18.2% during that period.

In addition, the release says, about 25% of white Medicare beneficiaries were using CGMs in 2019, compared to 12% of Black beneficiaries, and the gap had widened since 2017. Both insulin pumps and CSGs are regarded as important tools for controlling diabetes.

The study’s authors used data from Medicare’s fee-for-service database to determine the prevalence of diabetes technology use by race and ethnicity. They found that while CGM and insulin pump use grew among all groups during the period under study, the increase was greatest among white beneficiaries.

“Previous studies in non-Medicare beneficiaries point to socio-economic status as the key driver of unequal adoption of diabetes technology, but our study shows many other contributing factors,” Robert Vigersky, M.D., chief medical officer of medical device manufacturer Medtronic Diabetes says in the release. Medtronic Diabetes funded the research.

The other factors he cites include unconscious bias among health care providers who may think people of color aren’t able to use the technologies, cultural barriers, low health literacy and limited access to endocrinologists. “We need to address the social determinants of health, including race and ethnicity, before all aspects of diabetes care become more equitable,” said Vigersky,

The study, “Inequity in Adoption of Advanced Diabetes Technologies Among Medicare Fee-for-Service Beneficiaries,” was published online, ahead of print by the Endocrine Society.