O-21: “We can achieve it together”: increased utilization of insulin pumps and improving health equity among youth with type 1 diabetes: a unique, multi-disciplinary quality improvement initiative
K Gandhi, B Edwards, K Yuhas, E Searle, T Sapper, G Stewart, M Rice, M Abdelhadi, D Buckingham, J Indyk, M KambojAbstract
Introduction
Insulin pump use can improve glycemic control and decrease acute complications among youth with type 1 diabetes (T1D). Multiple barriers with insulin pump adoption among youth with T1D exist.
Objectives
This project aims to optimize insulin pump utilization and reduce health inequities among youth with T1D at a large tertiary care hospital through innovative quality improvement and equity initiatives.
Methods
Baseline data was collected to identify pump utilization and disparity data among youth in the T1D clinic. Multiple interventions include improving provider/patient awareness of pump use, family focus groups, reducing cost barriers, providing translation services, “on demand” pump classes, and innovative inter-disciplinary clinic workflows to enhance pump initiation and support. This project also established collaborative partnerships with the school-based diabetes program and institutional pediatric accountable care/care navigation organization.
Results
Baseline insulin pump was utilized in 30% of the patient population. Through these interventions, insulin pump use has increased to 71% among total youth with T1D. While pump use among Black youth with T1D is 25% lower compared to White youth with T1D, the pump disparity ratio in insulin pump use between Black and White patients improved from 0.42 in January 2024 to 0.57 in December 2025, representing a 36% relative improvement over two years, and the overall trend indicates steady progress in reducing racial disparities in pump utilization.
Conclusions
Developing innovative solutions by addressing social determinants of health, patient/provider awareness/barriers, and enhancing unique multi-disciplinary partnerships can lead to increased insulin pump utilization and improved diabetes care among a large, diverse population with T1D. Future steps include a home health diabetes partnership, inclusive media campaign, and promoting attendance and insulin pump use among minority populations at diabetes camps.