ASIDE INTERNAL MEDICINE 20 ASIDE Internal Medicine * Corresponding author: Mahmoud Nassar, MD, PhD, Department of Medicine, Division of Endocrinology, Diabetes and Metabolism, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, New York, USA. Email Address: Dr.Nassar@aucegypt.edu ISSN (Print) 3065-9671, ISSN (Online) 3065-968X – see front matter © 2024 ASIDE Internal Medicine. This work is licensed under a Creative Commons Attribution 4.0 International License. Hosting by ASIDE Journals. All rights reserved. Citation: Nassar M, Azzam AY, Morsy MM, Patoli I, Gill A, Marte E. Investigating Racial Disparities in Insulin Pump Use Among People with Type 1 Diabetes Across the United States: A Retrospective Multicenter Study. ASIDE Int Med. 2024;1(1). doi: 10.71079/ASIDE.IM.0000012262412 https://doi.org/10.71079/ASIDE.IM.0000012262412 Journal homepage: https://asidejournals.com/index.php/internal-medicine Original Article Investigating Racial Disparities in Insulin Pump Use Among People with Type 1 Diabetes Across the United States: A Retrospective Multicenter Study Mahmoud Nassar 1 *, Ahmed Y. Azzam 2 , Mahmoud M. Morsy 3 , Iqra Patoli 1 , Angad Gill 1 , Erlin J. Marte 4 1- Department of Medicine, Division of Endocrinology, Diabetes and Metabolism, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, New York, USA. 2- Montefiore-Einstein Cerebrovascular Research Lab, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA. 3- Faculty of Medicine, October 6 University, 6th of October City, Giza, Egypt. 4- Chief of Endocrinology, Director of Endocrine and Diabetes Department at VA Western New York Health Care, Veterans Affairs, Buffalo, NY, USA. A R T I C L E I N F O Article history: Received 02 Dec. 2024 Received in revised form 24 Dec. 2024 Accepted 26 Dec. 2024 Keywords: Racial Disparity Diabetes Insulin Pump Real-World Evidence CGM A B S T R A C T Introduction: Despite technological advances in Type 1 Diabetes Mellitus (T1D) management, racial disparities in insulin pump utilization persist. We investigated patterns of insulin pump adoption across different racial groups using a large-scale, multi-institutional database to quantify these disparities and identify potential intervention points. Methods: We conducted a retrospective cohort study using the TriNetX research network, analyzing data from 978,665 T1D patients across 66 healthcare organizations. Propensity score matching was employed to balance cohorts, with a focused sub-analysis of Buffalo, NY (n=6,080) to examine regional variations in comparison to the United States nationwide present data. Results: Nationwide data revealed significant racial disparities in insulin pump utilization, with White patients showing the highest adoption rate (11.74%) compared to Black or African American (AA) patients (4.056%). Buffalo cohort demonstrated higher overall adoption rates but maintained similar disparity patterns (White: 30.18%, Black or AA: 13.75%). Post-matching analysis confirmed these disparities persisted independent of demographic factors. Conclusions: Our findings reveal significant racial disparities in insulin pump adoption, with regional variations suggesting the influence of institutional factors. These results highlight the need for targeted interventions to promote equitable access to diabetes technology and prevent the widening of health disparities in T1D care.