scholarly journals T1D Exchange Quality Improvement Collaborative: A Learning Health System to Improve Outcomes for All People With Type 1 Diabetes

2021 ◽  
Author(s):  
Ruth S. Weinstock ◽  
Priya Prahalad ◽  
Nicole Rioles ◽  
Osagie Ebekozien

Medical advances, including the development of new medications and advanced technologies, have the potential to improve outcomes for youths and adults with type 1 diabetes, but that potential has not yet been fully realized, particularly in minority groups and those with low socioeconomic status (SES).

2021 ◽  
Author(s):  
Ruth S. Weinstock ◽  
Priya Prahalad ◽  
Nicole Rioles ◽  
Osagie Ebekozien

Medical advances, including the development of new medications and advanced technologies, have the potential to improve outcomes for youths and adults with type 1 diabetes, but that potential has not yet been fully realized, particularly in minority groups and those with low socioeconomic status (SES).


2021 ◽  
pp. cd210028
Author(s):  
Shideh Majidi ◽  
Osagie Ebekozien ◽  
Nudrat Noor ◽  
Sarah K. Lyons ◽  
Ryan McDonough ◽  
...  

2021 ◽  
Author(s):  
Sarah K. Lyons ◽  
Osagie Ebekozien ◽  
Ashley Garrity ◽  
Don Buckingham ◽  
Ori Odugbesan ◽  
...  

Insulin pump therapy in pediatric type 1 diabetes has been associated with better glycemic control than multiple daily injections. However, insulin pump use remains limited. This article describes an initiative from the T1D Exchange Quality Improvement Collaborative aimed at increasing insulin pump use in patients aged 12–26 years with type 1 diabetes from a baseline of 45% in May 2018 to >50% by February 2020. Interventions developed by participating centers included increasing in-person and telehealth education about insulin pump technology, creating and distributing tools to assist in informed decision-making, facilitating insulin pump insurance approval and onboarding processes, and improving clinic staff knowledge about insulin pumps. These efforts yielded a 13% improvement in pump use among the five participating centers, from 45 to 58% over 22 months.


2021 ◽  
pp. cd210027
Author(s):  
Sarah K. Lyons ◽  
Osagie Ebekozien ◽  
Ashley Garrity ◽  
Don Buckingham ◽  
Ori Odugbesan ◽  
...  

2021 ◽  
Author(s):  
Sarah K. Lyons ◽  
Osagie Ebekozien ◽  
Ashley Garrity ◽  
Don Buckingham ◽  
Ori Odugbesan ◽  
...  

Insulin pump therapy in pediatric type 1 diabetes has been associated with better glycemic control than multiple daily injections. However, insulin pump use remains limited. This article describes an initiative from the T1D Exchange Quality Improvement Collaborative aimed at increasing insulin pump use in patients aged 12–26 years with type 1 diabetes from a baseline of 45% in May 2018 to >50% by February 2020. Interventions developed by participating centers included increasing in-person and telehealth education about insulin pump technology, creating and distributing tools to assist in informed decision-making, facilitating insulin pump insurance approval and onboarding processes, and improving clinic staff knowledge about insulin pumps. These efforts yielded a 13% improvement in pump use among the five participating centers, from 45 to 58% over 22 months.


2021 ◽  
pp. 193229682110497
Author(s):  
Daniel J. DeSalvo ◽  
Nudrat Noor ◽  
Cicilyn Xie ◽  
Sarah D. Corathers ◽  
Shideh Majidi ◽  
...  

Background: The benefits of Continuous Glucose Monitoring (CGM) on glycemic management have been demonstrated in numerous studies; however, widespread uptake remians limited. The aim of this study was to provide real-world evidence of patient attributes and clinical outcomes associated with CGM use across clinics in the U.S. based T1D Exchange Quality Improvement (T1DX-QI) Collaborative. Method: We examined electronic Health Record data from eight endocrinology clinics participating in the T1DX-QI Collaborative during the years 2017-2019. Results: Among 11,469 type 1 diabetes patients, 48% were CGM users. CGM use varied by race/ethnicity with Non-Hispanic Whites having higher rates of CGM use (50%) compared to Non-Hispanic Blacks (18%) or Hispanics (38%). Patients with private insurance were more likely to use CGM (57.2%) than those with public insurance (33.3%) including Medicaid or Medicare. CGM users had lower median HbA1c (7.7%) compared to nonusers (8.4%). Rates of diabetic ketoacidosis (DKA) and severe hypoglycemia were significantly higher in nonusers compared to CGM users. Conclusion: In this real-world study of patients in the T1DX-QI Collaborative, CGM users had better glycemic control and lower rates of DKA and severe hypoglycemia (SH) events, compared to nonusers; however, there were significant sociodemographic disparities in CGM use. Quality improvement and advocacy measures to promote widespread and equitable CGM uptake have the potential to improve clinical outcomes.


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