University of Florida study uncovers equity disparity within Type 1 diabetes community

Insulin(Ruelle Fludd)
Updated: May. 21, 2021 at 2:30 PM EDT
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GAINESVILLE, Fla. (WCJB) -Cost and accessibility are issues within the Type 1 diabetic community that challenge people in managing the disease. Results from a study on Type 1 diabetics at the University of Florida found that both those factors play a role, but the main issue is negative interactions with the specialist or an endocrinologist.

“It’s our role to listen, we need to receive knowledge not just impart knowledge,” said Director of Equity Initiatives at the UF Diabetes Institute, Dr. Ashby Walker. “They felt a sense of being judged, they felt a sense that they were doing something wrong.”

The study targeted Type 1 diabetics who have missed two or more endocrinology appointments, have experienced diabetes-related complications in the past year and receive primary care at a federally qualified health center. This focus is meant to include minority communities who fall under those parameters. Participants say going to the endocrinologist doesn’t help to manage diabetes or morale.

“We have to include the endocrinologist in understanding the perceptions of people who come into their clinics and fears and concerns,” added Dr. Walker. “The experience of being demeaned or belittled, whether it’s intended or not was experienced by many of our participants.”

RELATED STORY: UF Health researchers develop system to track diabetes in children

Continuous glucose monitors or a CGM are the most effective way to manage type one diabetes and it’s not easy to get one. The study found when people from minority or low-income groups report negative and belittling interactions with their endocrinologist, they stop going to appointments.

“We also have to address it from the endocrinologist perspective of being able to understand what that would feel like if you were someone who is facing a very serious health complication and you want a tool to improve your health and you’re being told no,” mentioned Dr. Walker.

“And so really I think it’s multi-layered interventions but the one that we haven’t addressed as a field is implicit bias.”

In turn, patients say they don’t see the benefit in going to appointments— despite the fact that the best way to manage the disease is through a CGM, obtained with an endocrinologist’s approval.

Project ECHO Diabetes at UF is one way to break down barriers for patients managing the disease. The program not only helps people navigate life with diabetes but also gives primary care providers tools to better serve marginalized communities.

Read a full copy of the UF study here: Barriers to Technology Use and Endocrinology Care for Underserved Communities With Type 1 Diabetes

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