Original Investigation

Social Determinants of Health and Continuous Glucose Monitoring Metrics in Type 1 or Type 2 Diabetes

JAMA Network Open 10.1001/jamanetworkopen.2026.21290

July 01, 2026 at 11:00 AM EDT

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Are race and ethnicity, health insurance type, and socioeconomic disadvantage associated with differences in glycemic management among adults and children using continuous glucose monitoring (CGM)?In this cross-sectional study of 1743 patients, non-Hispanic Black race, public health insurance, and greater socioeconomic disadvantage were significantly associated with diminished glycemic management, including lower time in range and higher glycemic risk index, even after adjusting for insulin pump use. These associations were most pronounced among children.These findings suggest that access to advanced diabetes technologies alone may be insufficient to overcome sociodemographic differences in glycemic outcomes, highlighting the need for complementary support strategies.

Corresponding Author: Irina Gaynanova, PhD, Department of Biostatistics, School of Public Health, University of Michigan, 1415 Washington Hts, Ann Arbor, MI 48109-1079 (irinagn@umich.edu).

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