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News
Where you live in the US dramatically shapes your access to type 1 diabetes (T1D) care. A new JAMA Network Open study reveals wide state-level gaps in T1D incidence and even starker disparities in pediatric endocrinologist availability — with some states having up to 17 times fewer specialists per young patient than others. Experts warn the shortage could worsen as new treatments and screening programs expand demand.
A new cross-sectional study published in JAMA Network Open finds that both the burden of type 1 diabetes (T1D) and access to specialist care vary dramatically across US states — raising alarms at a time when treatment options are rapidly advancing. Researchers used 2024 data from the T1D Index and the SEARCH for Diabetes in Youth Study to estimate state-level T1D incidence and prevalence, while also mapping the pediatric endocrinology workforce.
The geographic gaps in specialist availability are especially striking. Idaho and Wyoming have fewer than 3.5 pediatric endocrinologists per 1,000 young T1D patients, while the District of Columbia has 46.4 — a nearly 17-fold difference. Experts note that even these numbers may overstate real-world access, since board certification doesn't account for telehealth, cross-border care, or providers who've stepped back from clinical practice.
By the Numbers:
Why it matters: With T1D screening expanding, new immunomodulatory drugs entering the market, and diabetes technology advancing fast, demand for pediatric endocrinologists is set to grow — making these existing disparities a serious equity concern for children who stand to benefit most from modern care.
