Background: There are racial disparities in the treatment and outcomes of children with type 1 diabetes (T1D). Patient SES has been proposed as a factor to explain the disparities. Technological advances (insulin pumps and continuous glucose monitoring(CGM)) have made optimal diabetes outcomes more achievable. The purpose of this study was to compare glycemic control and the utilization of diabetes technology in African American(AA) versus white children with T1D, using health insurance status as a surrogate for SES. Methods: White and AA children <18 yrs, with T1D >1 yr, attending a large diabetes center were included in a record review. Prevalence rates for insulin pump and CGM use, and for glycemic control (HbA1C), were examined for each race, with data stratified by insurance status. Results: 1322 children [699 (52.9%)male; 244 (18.5%)AA] with a mean(+SD) age of 13.3+3.5 and T1D duration 6+3.7 yrs, were included. Among those with public insurance- a higher proportion were AA (60.2% v 21.1%, p<0.001), fewer AA children used diabetes technology (CGM: 8.1 v 36%, p<0.001; insulin pumps: 17.1 v 45.5%, p<0.001) and AA had poorer glycemic control (9.9 v 8.8%, p<0.001). Similarly, in those with private insurance, fewer AA children used CGM (24 v 49.4%, P<0.001) or insulin pumps (31.6 v 64.7%, P<0.001) and AA had worse glycemic control (9.3 v 8.2%, p<0.001). Conclusions: Racial disparities in treatment and outcomes of children with T1D persist as technology advances, even for those with private insurance. Provider bias should be explored when studying factors that contribute to these disparities.