ArticleDiabetes, obesity & metabolism2026
Timing of insulin pump initiation among individuals 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.
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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.
- Timing of insulin pump initiation among individuals with type 1 diabetes in Ontario, Canada.Diabetes, obesity & metabolism · 2026Article
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Authors and funding
6 authors.
Funding
Abstract
aimsTo assess characteristics associated with earlier (≤2 years since diagnosis) versus later (>2 years) insulin pump initiation among new type 1 diabetes applicants to the publicly funded insulin pump program in Ontario, and whether timing of pump initiation is associated with cumulative glycaemic exposure. MATERIALS AND
methodsA retrospective population-based cohort study was conducted using administrative healthcare databases in Ontario, Canada. All pump program applicants prior to 31 March 2021 were included. An adjusted log-binomial regression model using generalized estimating equations assessed associations between patient- and physician-level characteristics and earlier versus later pump initiation. A linear regression model examined differences in cumulative HbA1c over time between earlier versus later pump initiators.
resultsAmong 4899 individuals, 62.6% were earlier pump initiators. Greater social disadvantage was associated with lower likelihood of earlier pump initiation [adjusted relative risk (RR) 0.81 (95% confidence interval {CI} 0.75-0.88)] for most versus least disadvantaged quintile. Compared to paediatrician care, endocrinologist [RR 0.85 (95% CI 0.79, 0.91)], general internist [0.73 (0.64-0.83)], and family physician care [0.28 (0.21-0.37)] were associated with less earlier pump initiation. Older age at diagnosis and physician training prior to publicly funded pump therapy were associated with less earlier pump initiation. Earlier pump initiators had a significantly lower annual rate of increase in cumulative HbA1c compared with later initiators (-0.33% per year; 95% CI -0.45 to -0.20; p < 0.001), although cumulative HbA1c at 10 years did not differ significantly between groups (mean difference -1.50; p = 0.112).
conclusionsSocial disadvantage and physician characteristics are associated with less earlier pump initiation, which may have negative long-term effects on glycaemic management. Barriers to earlier pump initiation should be removed to promote equitable access and optimize glycaemic outcomes.
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