Access to Modern Technologies, Insulin Affects HbA1c Levels in Pediatric Type 1 Diabetes

WEDNESDAY, Sept. 3, 2025 (HealthDay News) — For children with type 1 diabetes (T1D), glycated hemoglobin (HbA1c) levels are associated with accessibility of modern diabetes technologies and insulin, according to a study published online Aug. 27 in JAMA Network Open.

Alzbeta Santova, M.D., from Motol University Hospital and Second Faculty of Medicine in Prague, Czechia, and colleagues describe how accessibility and reimbursement of advanced diabetes technologies and insulin are associated with HbA1c levels in centers participating in the international pediatric diabetes registry (SWEET initiative). Data were collected from 81 centers in 56 countries; HbA1c levels were included from 42,349 children with T1D.

The researchers found that 32 centers from 19 countries reported universal access with complete reimbursement for all technologies and insulin; eight countries reported no reimbursement for any technologies or insulin. Mean HbA1c levels were 7.62 to 7.75 percent for centers with full reimbursement for continuous glucose monitoring, continuous subcutaneous insulin infusion, glucometers, and insulin compared with 9.65 to 10.49 percent in centers with no reimbursement and/or no availability.

“We conclude that the greatest challenge to achieving global equity in diabetes outcomes lies in the unequal access to modern technologies for all children with T1D,” the authors write. “These data serve as a call to accelerate ongoing initiatives and inspire new, innovative solutions aimed at closing these gaps.”

Several authors disclosed ties to the pharmaceutical industry; the SWEET e.V. Registry is funded by SWEET members, including pharmaceutical companies.

Abstract/Full Text

Editorial