TY - JOUR
AU - S. Seidu
AU - J. Tetteh
AU - S. Kunutsor
AU - P. Choudhary
AU - K. Khunti
AU - R. A. Ajjan
A1 - 
AB - BACKGROUND: Diabetes affects over 3.3 million people in England, creating a significant health and economic burden. Continuous glucose monitoring (CGM) improves diabetes management but remains unevenly accessible, especially among Black and minority groups who face onset at younger ages, higher diabetes rates and complications. Updated NICE guidelines promote CGM access for all people with T1D and certain people with T2D, yet data on prescribing patterns in England are limited. This study investigates CGM prescribing across integrated care boards (ICBs) and primary care networks (PCNs), focusing on ethnicity and deprivation, to identify and address access disparities. METHODS: Cross-sectional analysis of publicly available data examined CGM prescribing patterns across England's PCNs, focusing on ethnicity and socio-economic factors. Data from OpenPrescribing, the National Diabetes Audit and Public Health England were analysed through descriptive and inferential statistics, including regression and Intraclass Correlation Coefficient (ICC) calculations, to assess disparities in prescribing ratio per 1000 people. RESULTS: Significant disparities in CGM prescribing across PCNs and ICBs are identified, shaped by ethnicity, age and socio-economic factors. The mean items prescription ratio is 4.87 per 1000 people, ranging from 0.26 to 11.59. People with T1D are generally younger, with only 15.5% over 65, compared to 52.0% in T2D. White individuals represent 83.6% of T1D cases, while South Asians and Afro-Caribbeans are more prevalent in T2D (14.5% and 5.3%, respectively). ICBs with below-average CGM prescribing have a higher percentage of Afro-Caribbean and South Asian populations compared to ICBs with above-average prescribing. For T1D, Afro-Caribbean representation is 6.7 (SD:7.0) in lower-prescribing ICBs versus 2.1 (SD:2.8) in higher-prescribing ICBs, and for T2D, it is 8.4 (10.4) versus 1.8 (SD:3.4) South Asian representation in low-prescribing ICBs is 10.6 (SD:13.7) for T1D and 21.9 (SD:20.5) for T2D, compared to 3.2 (SD:4.9) for T1D and 6.5 (SD:9.7) for T2D in higher-prescribing ICBs. CGM prescribing variance attributed to ethnicity and deprivation is 46.6% in T1D and 77.3% in T2D, indicating considerable socio-demographic impact. CONCLUSION: This study reveals significant ethnic disparities in CGM access, with Afro-Caribbean and South Asian groups facing a reduced prescribing ratio per 1000 people. Consistent NICE guideline adoption and targeted outreach are needed to improve equity in CGM access.
AD - Leicester Real World Evidence Unit, Leicester Diabetes Centre, Leicester, UK.; Leicester Diabetes Research Centre, University Hospital Leicester, Leicester General Hospital, Leicester, UK.; Division of Musculoskeletal and Dermatological Sciences, School of Biological Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, England, UK.; Section of Cardiology, Department of Internal Medicine, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Saint Boniface Hospital, Winnipeg, Manitoba, Canada.; Clinical Population and Sciences Department, Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, UK.
AN - 40903852
BT - Diabet Med
C5 - Healthcare Disparities
CP - 11
DA - Nov
DO - 10.1111/dme.70130
DP - NLM
ET - 20250903
IS - 11
JF - Diabet Med
LA - eng
N2 - BACKGROUND: Diabetes affects over 3.3 million people in England, creating a significant health and economic burden. Continuous glucose monitoring (CGM) improves diabetes management but remains unevenly accessible, especially among Black and minority groups who face onset at younger ages, higher diabetes rates and complications. Updated NICE guidelines promote CGM access for all people with T1D and certain people with T2D, yet data on prescribing patterns in England are limited. This study investigates CGM prescribing across integrated care boards (ICBs) and primary care networks (PCNs), focusing on ethnicity and deprivation, to identify and address access disparities. METHODS: Cross-sectional analysis of publicly available data examined CGM prescribing patterns across England's PCNs, focusing on ethnicity and socio-economic factors. Data from OpenPrescribing, the National Diabetes Audit and Public Health England were analysed through descriptive and inferential statistics, including regression and Intraclass Correlation Coefficient (ICC) calculations, to assess disparities in prescribing ratio per 1000 people. RESULTS: Significant disparities in CGM prescribing across PCNs and ICBs are identified, shaped by ethnicity, age and socio-economic factors. The mean items prescription ratio is 4.87 per 1000 people, ranging from 0.26 to 11.59. People with T1D are generally younger, with only 15.5% over 65, compared to 52.0% in T2D. White individuals represent 83.6% of T1D cases, while South Asians and Afro-Caribbeans are more prevalent in T2D (14.5% and 5.3%, respectively). ICBs with below-average CGM prescribing have a higher percentage of Afro-Caribbean and South Asian populations compared to ICBs with above-average prescribing. For T1D, Afro-Caribbean representation is 6.7 (SD:7.0) in lower-prescribing ICBs versus 2.1 (SD:2.8) in higher-prescribing ICBs, and for T2D, it is 8.4 (10.4) versus 1.8 (SD:3.4) South Asian representation in low-prescribing ICBs is 10.6 (SD:13.7) for T1D and 21.9 (SD:20.5) for T2D, compared to 3.2 (SD:4.9) for T1D and 6.5 (SD:9.7) for T2D in higher-prescribing ICBs. CGM prescribing variance attributed to ethnicity and deprivation is 46.6% in T1D and 77.3% in T2D, indicating considerable socio-demographic impact. CONCLUSION: This study reveals significant ethnic disparities in CGM access, with Afro-Caribbean and South Asian groups facing a reduced prescribing ratio per 1000 people. Consistent NICE guideline adoption and targeted outreach are needed to improve equity in CGM access.
PY - 2025
SN - 0742-3071 (Print); 0742-3071
SP - e70130
ST - Prescription distribution and inequities in diabetes care: A comparative analysis of continuous glucose monitoring access by diabetes status, ethnicity and socio-economic factors in England
T1 - Prescription distribution and inequities in diabetes care: A comparative analysis of continuous glucose monitoring access by diabetes status, ethnicity and socio-economic factors in England
T2 - Diabet Med
TI - Prescription distribution and inequities in diabetes care: A comparative analysis of continuous glucose monitoring access by diabetes status, ethnicity and socio-economic factors in England
U1 - Healthcare Disparities
U3 - 10.1111/dme.70130
VL - 42
VO - 0742-3071 (Print); 0742-3071
Y1 - 2025
ER -