sj-docx-1-dst-10.1177_19322968231223726 – Supplemental material for Machine Learning Models for Prediction of Diabetic Microvascular Complications

Supplemental material, sj-docx-1-dst-10.1177_19322968231223726 for Machine Learning Models for Prediction of Diabetic Microvascular Complications by Sarah Kanbour, Catharine Harris, Benjamin Lalani, Risa M. Wolf, Hugo Fitipaldi, Maria F. Gomez and Nestoras Mathioudakis in Journal of Diabetes Science and Technology</p

Racial Disparities in Access and Use of Diabetes Technology Among Adult Patients with Type 1 Diabetes in a U.S. Academic Medical Center

   Objective: Recent studies highlight racial disparities in insulin pump (PUMP) and continuous glucose monitor (CGM) use in children and adolescents with type 1 diabetes (T1D). This study explored racial disparities in diabetes technology among adult patients with T1D. Research Design and Methods: Retrospective clinic-based cohort study of adult patients with T1D seen consecutively from April 2013 to January 2020. Race was categorized into non-Black (reference group) and Black. The primary outcomes were baseline and prevalent technology use, rates of diabetes technology discussions (CGMdiscn, PUMPdiscn), and prescribing (CGMrx, PUMPrx). Multivariable logistic regression analysis evaluated the association of technology discussions and prescribing with race, adjusting for social determinants of health and diabetes outcomes.  Results:  Among 1,528 adults with T1D, baseline technology use was significantly lower for Black compared to non-Black patients (7.9% vs. 30.3% for CGM; 18.7% vs. 49.6% for pump), as was prevalent use (43.6% vs. 72.1% for CGM; 30.7% vs. 64.2% for pump). Black patients had adjusted odds ratios (aORs) of 0.51 (95% CI, 0.29, 0.90) and 0.61 (95% CI, 0.41, 0.93) for CGMdiscn and CGMrx, respectively. Black patients had aORs of 0.74 (95% CI, 0.44, 1.25) and 0.40 (95% CI, 0.22, 0.70), for PUMPdiscn and PUMPrx, respectively. Neighborhood context, insurance, marital and employment status, and number of clinic visits were also associated with the outcomes. Conclusions and Relevance: Significant racial disparities were observed in discussions, prescribing, and use of diabetes technology. Further research is needed to identify the causes behind these disparities and develop and evaluate strategies to reduce them.</p

<b>Understanding Providers’ Readiness and Attitudes Toward Autoantibody Screening: A Mixed-Methods Study</b>

Screening for autoantibodies associated with type 1 diabetes can identify people most at risk for progressing to clinical type 1 diabetes and can provide an opportunity for early intervention. Drawbacks and barriers to screening exist, and concerns arise, as methods for disease prevention are limited and no cure exists today. The availability of novel treatment options such as teplizumab to delay progression to clinical type 1 diabetes in high-risk individuals has led to the reassessment of screening programs. This study explored awareness, readiness, and attitudes of endocrinology providers toward type 1 diabetes autoantibody screening.</p