Evidence map›Paper›PMID 36419466›Full record

ArticleThe Lancet regional health. Western Pacific2023

Inequity in access to continuous glucose monitoring and health outcomes in paediatric diabetes, a case for national continuous glucose monitoring funding: A cross-sectional population study of children with type 1 diabetes in New Zealand.

Mercedes J Burnside, Jonathan A Williman, Hannah M Davies, Craig A Jefferies, Ryan G Paul, Benjamin J Wheeler, Esko J Wiltshire, Yvonne C Anderson, Martin I de Bock

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in The Lancet regional health. Western Pacific, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 29 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
29citing papers in PubMed, 3 pooled it
5.7field-weighted citation impact, top 3% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

29 citing papers in PubMed, 3 syntheses or guidelines pooled it, 45 citations in OpenAlex.

  1. Continuous glucose monitoring in type 2 diabetes: a systematic review of barriers and opportunities for care improvement.International journal for quality in health care : journal of the International Society for Quality in Health Care · 2025
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

9 authors at 4 institutions in 2 countries.

Mercedes J BurnsidePaediatric Department, University of Otago, Christchurch, Terrace House, 4 Oxford Terrace, Christchurch, New Zealand.
Jonathan A WillimanBiostatistics and Computation Biology Unit, University of Otago, Christchurch, New Zealand.
Hannah M DaviesPaediatric Department, University of Otago, Christchurch, Terrace House, 4 Oxford Terrace, Christchurch, New Zealand.
Craig A JefferiesPaediatric Diabetes and Endocrinology, Starship Children's Health, Auckland, New Zealand.
Ryan G PaulWaikato Regional Diabetes Service, Waikato District Health Board, Hamilton, New Zealand.
Benjamin J WheelerDepartment of Women's and Children's Health, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand.
Esko J WiltshireDepartment of Paediatrics and Child Health, University of Otago, Wellington, New Zealand.
Yvonne C AndersonDepartment of Paediatrics: Child and Youth Health, Faculty of Medicine and Health Sciences, University of Auckland, Auckland, New Zealand.
Martin I de BockPaediatric Department, University of Otago, Christchurch, Terrace House, 4 Oxford Terrace, Christchurch, New Zealand.
University of Otago · NZStarship Children's Health · NZUniversity of Auckland · NZWaikato District Health Board · NZ

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Continuous glucose monitoring (CGM) improves glycaemia for people affected by type 1 diabetes (T1D), but is not funded in Aotearoa/New Zealand. This study explores the impact of non-funded CGM on equity of access and associated glycaemic outcomes. Methods: Cross-sectional population-based study collected socio-demographic (age, gender, prioritised ethnicity, socioeconomic status) and clinical data from all regional diabetes centres in New Zealand with children <15 years with T1D as of 1st October 2021. De-identified data were obtained from existing databases or chart review. Outcomes compared socio-demographic characteristics between those using all forms of CGM and self-monitoring of blood glucose (SMBG), and association with HbA1c. Findings: 1209 eligible children were evaluated: 70.2% European, 18.1% Māori, 7.1% Pacific, 4.6% Asian, with even distribution across socioeconomic quintiles. Median HbA1c was 64 mmol/mol (8.0%), 40.2% utilised intermittently scanned (is)CGM, and 27.2% real-time (rt)CGM. CGM utilisation was lowest with Pacific ethnicity (38% lower than Māori) and the most deprived socioeconomic quintiles (quintile 5 vs. 1 adjusted RR 0.69; 95% CI, 0.57 to 0.84). CGM use was associated with regional diabetes centre (P < 0.001). The impact of CGM use on HbA1c differed by ethnicity: Māori children had the greatest difference in HbA1c between SMBG and rtCGM (adjusted difference -15.3 mmol/mol; 95% CI, -21.5 to -9.1), with less pronounced differences seen with other ethnicities. Interpretation: Inequities in CGM use exist based on prioritised ethnicity and socioeconomic status. Importantly, CGM was independently associated with lower HbA1c, suggesting that lack of CGM funding contributes to health disparity in children with T1D. Funding: Australasian Paediatric Endocrine Group (APEG), Canterbury Medical Research Foundation, Starship Foundation.

Indexed as

Continuous glucose monitoringDiabetes technologyDisparityEquityPaediatricsType 1 diabetes

Identifiers

PMID36419466
PMCPMC9676142
OpenAlexW4309626180

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.