Evaluation report
Real-world pediatric diabetes technology adoption and integration after subsidization expansion: a Repeated Cross-Sectional Study
Tesch Z, Ujházi T, Buzás N ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This study examined how Hungary's expansion of subsidized access to diabetes management technologies (continuous glucose monitors and insulin pumps) from 2020 onwards affected adoption rates among children and young adults with type 1 diabetes. Comparing data from 2018 and 2025, the researchers found that continuous glucose monitor use increased substantially while insulin pump adoption rose more modestly. Three distinct patient groups emerged with different technology adoption patterns, suggesting that financial access alone does not guarantee that all families will adopt available technologies.
Key points
- Continuous glucose monitor (CGM) use increased markedly following subsidization expansion
- Insulin pump use rose modestly, remaining strongly associated with patient cluster membership
- Three distinct self-management groups were identified: safety seekers, hesitant adopters, and technology frontrunners
- CGM use became dominant across all patient groups
- Expanded subsidization alone did not ensure full technology integration; access does not overcome all barriers to adoption
Limitations
The study is limited to Hungary and may not represent technology adoption patterns in other healthcare systems with different financing structures. The study does not evaluate clinical outcomes or health improvements resulting from increased technology use.
Abstract
Abstract Since 2020, Hungary has expanded social security support for modern diabetes treatment devices (CGMs and insulin pumps), enabling near-universal access for children under 18 and young adults in higher education under 24. This study assessed how changes influenced the adoption of diabetes technologies and self-management pathways. Repeated cross-sectional studies were conducted in 2018 (n = 318) and 2025 (n = 417) among caregivers of children with type 1 diabetes and online questionnaires. Device use, reasons for acceptance or rejection, and perceptions of subsidization were analyzed. Cluster analysis identified self-management patterns, and sensitivity analyses adjusted for age distribution and diabetes duration. CGM use increased markedly, while traditional blood glucose meter use decreased. Insulin pump use rose modestly. Three distinct patient groups emerged: safety seekers, hesitant adopters, and technology frontrunners. CGM use was dominant in all groups, whereas insulin pump use remained strongly associated with cluster membership. Sensitivity analyses confirmed that the rise in CGM use was robust to variations in age composition and diabetes duration. Expanded subsidization was associated with a substantial increase in CGM adoption. Persistent differences in device use indicate that access alone does not ensure full technology integration: the financing structure may influence therapeutic practices, decision-making culture, adaptation patterns, and self-management strategies.
Findings the Hub has extracted
Each claim below is labelled by its type of design and links back to this report.
- Intervention
- Expansion of social security subsidization for diabetes treatment devices to enable near-universal access for children under 18 and young adults under 24 in higher education
- Population
- Children with type 1 diabetes and young adults in higher education in Hungary; caregivers surveyed in 2018 (n=318) and 2025 (n=417)
Key finding
CGM use increased markedly following subsidization expansion from 2020