Recommendations from the United Kingdom UNBIASED Study to Address Diabetes Technology Access Disparities for Children and Young People

Abstract

Aims:

The UNBIASED UK study is the first national study that explores disparities in access to diabetes technology among children and young people (CYP) with type 1 diabetes (T1D) from ethnic minority and low socioeconomic backgrounds in the United Kingdom. Despite the National Institute for Health and Care Excellence guidance ensuring free universal access to diabetes technologies since 2023, significant inequities persist. This article outlines key barriers and provides recommendations to improve equitable access and engagement with diabetes technologies for CYP.

Methods:

A multimethod participatory approach was used, including semi-structured triad interviews with parents and CYP of underrepresented groups living in low socioeconomic areas and minority ethnic groups. Health care professionals from the National Health Service were also interviewed to explore perceived and systemic barriers to technology adoption. Thematic analysis identified key challenges and potential solutions, and new recommendations were sought from codesigned workshops and public consultations were further developed.

Results:

The UNBIASED study identified key themes from parents, children, and young people, including barriers to access, experiences with diabetes technology, inconsistent services and education, intersectional challenges, communication issues, and emotional support needs. Health care professionals highlighted financial limits, language barriers, regional service differences, unconscious bias, and low awareness as major factors contributing to disparities. Key strategies and new recommendations are made to improve fair access to diabetes technologies, including systemic reforms, better communication and support, and stronger community engagement.

Conclusions:

This UK UNBIASED study highlights the urgent need for standardized policies, increased awareness campaigns, culturally tailored education, peer support initiatives, and improved health care provider training to ensure equitable access to diabetes technology for all CYP with T1D in the United Kingdom.