ArticleDiabetes, obesity & metabolism2026
Impact of Removing Restrictive Haemoglobin A1C Eligibility Criteria for Insulin Pump Therapy Funding for Children With Type 1 Diabetes in Ontario, Canada.
Article in Diabetes, obesity & metabolism, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
What it found
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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.
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Who cites it
1 citing paper in PubMed.
- Impact of Removing Restrictive Haemoglobin A1C Eligibility Criteria for Insulin Pump Therapy Funding for Children With Type 1 Diabetes in Ontario, Canada.Diabetes, obesity & metabolism · 2026Article
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Authors and funding
4 authors.
Funding
Abstract
aimsIn Ontario, publicly funded insulin pump therapy has been available to children with Type 1 diabetes since 2006. Before 31 March 2022, eligibility required three Haemoglobin A1c (A1C) measurements in the preceding year, with the two most recent < 10%. On 1 April 2022, this criterion was removed. We assessed whether this policy change reduced socioeconomic disparities in pump access among new applicants. MATERIALS AND
methodsWe conducted a population-based retrospective cohort study including all children in Ontario who applied for insulin pump funding from program inception to 31 March 2024. The primary exposure was the time period (pre- vs. post-policy change). The outcome was social disadvantage, measured using a five-level neighbourhood index. Ordinal logistic regression with generalised estimating equations (accounting for neighbourhood clustering) estimated the odds of greater disadvantage post-policy, adjusting for age, sex and diabetes duration. Segmented regression assessed changes over time in differences in application proportions between the most and least disadvantaged quintiles.
resultsA total of 7540 children applied pre-policy and 1311 post-policy. The mean A1C at application was similar between time periods (8.5% vs. 8.3%, p = 0.0002). Adjusted odds of greater disadvantage were higher post-policy (OR: 1.32, 95% CI: 1.18-1.47). The difference in applications between the most versus least disadvantaged quintile decreased by 0.13%/quarter (95% CI: -0.22 to -0.05) pre-policy and by 1.64%/quarter (95% CI: -8.3 to 5.0) post-policy, though the pre versus post-policy difference was not statistically significant (p = 0.1).
conclusionsRemoval of A1C-based eligibility may improve equity in paediatric insulin pump access, though longer follow-up is needed.
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