1936-LB: The Challenge of Obtaining Diabetes Technology Supplies in Adults with Type 1 Diabetes

Abstract

Background: Individuals with Type 1 Diabetes (T1D) face barriers to reliably obtain prescribed technology supplies (continuous glucose monitors [CGM]/insulin pump supplies). The frequency of annual supply access interruptions (ASAI) and the associated burden (emotional, financial, time) with this process are unclear. Objective: To quantify ASAI of technology supplies/insulin and associated burden in adults with T1D. Methods: A 64-question online survey was distributed to the T1D Exchange registry for US adults with T1D. ASAI was defined as total instances that individuals ran out of CGM, insulin pump supplies, and/or insulin in the past year. The burden to obtain supplies was assessed by a 1-10 scale (10 = strongly agree). Means and SD were reported. Significance of comparisons was assessed with t-tests or ANOVA for parametric data, and Mann-Whitney or Kruskal-Wallis tests for non-parametric data (significant = p<0.05). Results: Responses were completed by 2151 surveyed. Mean age was 49 years, 73% female, average A1C 6.7%, with 96% and 80% utilizing CGM and insulin pumps respectively. ASAI averaged 1.8 and varied significantly based on gender (Female = 1.9), insurance (Medicaid = 3.9), income (None = 3.23), race (Black = 3.0), and location (Rural = 2.3). Emotional burden (worry about running out of supplies) was significantly higher in women, those without insurance, lower annual income, and non-white race. A 10 was reported for “It is difficult to afford supplies” by 13% and “I spend too much time obtaining supplies” by 11%. Early CGM and insulin pump cannula failures were reported by 45% and 48% of respondents respectively. The top reason for ASAI was “Required prior authorization” in 36% of respondents. The top strategies to avoid ASAI were “Call supply company to request extra supplies” (25.9%), and “Use supply for longer than recommended” (25.5%). Conclusion: Challenges in obtaining diabetes supplies are significant and disproportionately affect certain socioeconomic groups with T1D. Disclosure A.A. Welch: None. T. Knoerl: None. E.J. Kopras: None. S. Corathers: None. M. Falciglia: None.