ArticleDiabetes research and clinical practice2023
Glucagon fill rates and cost among children and adolescents with type 1 diabetes in the United States, 2011-2021.
Article in Diabetes research and clinical practice, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed, 10 citations in OpenAlex.
- 1. Improving Care and Promoting Health in Populations: Standards of Care in Diabetes-2026.Diabetes care · 2026Review
- 9. Pharmacologic Approaches to Glycemic Treatment: Standards of Care in Diabetes-2026.Diabetes care · 2026Review
- 6. Glycemic Goals, Hypoglycemia, and Hyperglycemic Crises: Standards of Care in Diabetes-2026.Diabetes care · 2026Review
- Disparities in technology utilization among youth with type 1 diabetes across diverse racial and socioeconomic backgrounds.BMJ open diabetes research & care · 2025Article
- 1. Improving Care and Promoting Health in Populations: Standards of Care in Diabetes-2025.Diabetes care · 2025Review
- 6. Glycemic Goals and Hypoglycemia: Standards of Care in Diabetes-2025.Diabetes care · 2025Review
- 9. Pharmacologic Approaches to Glycemic Treatment: Standards of Care in Diabetes-2025.Diabetes care · 2025 · on this mapReview
- Transmucosal glucagon rapidly increases blood glucose concentration in healthy cats.Journal of feline medicine and surgery · 2024Article
Corrections and comments
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Authors and funding
6 authors at 4 institutions in 1 country.
Funding
Abstract
aimsTo characterize glucagon fill rates and costs among youth with type 1 diabetes mellitus (T1DM).
methodsClaims-based analysis of commercially-insured youth with T1DM included in OptumLabs® Data Warehouse between 2011 and 2021. Glucagon fill rates and costs were calculated overall and by formulation (injectable, intranasal, autoinjector, and pre-filled syringe). Sociodemographic and clinical factors associated with glucagon fills were examined using Cox regression.
resultsWe identified 13,267 children with T1DM (76.4% non-Hispanic White). Over mean follow-up of 2.81 years (SD 2.62), 70.0% filled glucagon, with stable fill rates from 2011 to 2021. Intranasal glucagon had rapid uptake following initial approval, and it accounted for almost half (46.6%) of all glucagon fills by 2021. Family income was positively associated with glucagon fills in a stepwise fashion (HR 1.39 [95% CI 1.27-1.52] for annual household income ≥$200,000 vs. <$40,000), while Black race was negatively associated with fills (HR 0.83 [95% CI 0.76-0.91]) compared to White race). Annual mean out-of-pocket costs ranged from $21-$68 (IQR $29-$44).
conclusionRoughly 30% of commercially-insured youth with T1DM may lack access to unexpired glucagon, with significant disparities among Black and low-income patients. Health systems, clinicians, schools, and caregivers should work together to ensure children have reliable access to this critical medication.
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