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From June 20 to 23, 2025, many of the world’s leading scientists in diabetes research gathered in Chicago, Illinois, for the American Diabetes Association’s (ADA) 85th Scientific Sessions!
T1D Exchange showcased 13 posters and presentations at this year’s conference, covering topics ranging from continuous glucose monitoring (CGM) usage in people with type 2 diabetes (T2D) to musculoskeletal conditions in people with type 1 diabetes (T1D).
Check out the T1D Exchange research presented at this year’s Scientific Sessions and learn more about each of our studies at the links below!
Health Care Delivery
2073-LB: Teamwork, Targets, Technology, and Tight Range (4T) in New-Onset T1D—Comparing Outcomes and Rationale for Translation
Researchers in the T1DX-QI compared outcomes over one year from Stanford University, which designed and implemented a special program called “4T”, with 13 other pediatric clinics.
The 4T program had people with T1D start using technology sooner, set clear treatment goals, and provided remote support.
Key findings:
- Kids in the 4T clinic were almost 2.5 times more likely to reach A1C levels below 7.0%
- 97% of children at the 4T clinic used CGMs compared to 76% in other clinics.
- 50% in the 4T clinic had an A1C below 7.0% vs. 33% in other clinics.
- None of the 12 clinics had lower A1Cs or higher percentages of people with A1Cs below 7% than the 4T clinic.
In short, starting technology early and offering strong education and support helped more kids with T1D and their families have better outcomes.
1139-P: Assessing Clinic Readiness for Implementation of Equitable and Sustainable New-Onset Care in the T1DX-QI
This project explores how to bring the 4T Program, an early, equity-focused technology and education initiative, to more clinics across the U.S.
To expand this program, we surveyed 15 pediatric diabetes clinics in the T1D Exchange Quality Improvement Collaborative (T1DX-QI) to understand their resources and the challenges they might face when implementing the 4T Program.
Key findings:
- Clinics said their biggest barriers would be finding more staff time and better technical support to make the 4T Program work.
- Some clinics also mentioned needing stronger support for families and team buy-in.
These insights are being used to help clinics plan how to fairly and effectively offer enhanced care to people newly diagnosed with T1D.
1218-P: Benchmarking Ratio of Diabetes Providers to Number of People with Type 1 Diabetes across Nine Pediatric Centers
This work sought to understand how the nationwide shortage of endocrinologists affects care for children with T1D by analyzing the ratio of health care providers to people with T1D at nine pediatric endocrinology clinics. Some clinics face greater strain due to more people with T1D and fewer providers.
Key findings:
- Some clinics are under more pressure than others due to fewer available providers.
- On average, each physician has 216 patients, including 32 who are newly diagnosed.
- On average, 16% of people with T1D in a clinic were newly diagnosed.
- The number of patients per doctor varied widely, from fewer than 100 to more than 300 per provider.
The study highlights the urgent need for better staffing and support to meet the demand for diabetes care in children and teens.
1900-LB: Inpatient Education and Discharge Support in the T1D Exchange Quality Improvement Collaborative
We examined the inpatient care practices and hospital discharge support at 56 endocrinology clinics.
Key findings:
- Children’s hospitals more often automatically offer diabetes specialist consultations, start people on CGMs while in the hospital, and provide education from certified diabetes educators.
- Adult hospitals were less likely to know how often their patients are re-admitted and less likely to use tools to predict who is at risk of returning.
- Discharge support was also stronger in pediatric centers, with more checklists, coordinators, and patients leaving the hospital with medications.
- Only 11% of adults had a follow-up visit within two weeks of discharge, compared to nearly half of children.
2053-LB: Racial/Ethnic Distribution of People with Diabetes and Diabetes Center Staff—2024 T1D Exchange Quality Improvement Collaborative (T1DX-QI) Survey Results
We investigated how well diabetes care teams reflect the communities they serve. Our findings show a mismatch between the race and ethnicity of endocrinology clinic staff and their patients.
Key findings:
- Clinics reported a higher percentage of people with T2D identifying as part of racially and ethnically diverse populations, compared to people with T1D.
- Pediatric clinics reported that over 50% of children with T2D identify as racially or ethnically diverse.
- However, the staff at these clinics generally did not reflect that diversity. More than 80% of centers said that less than half of their staff identify as racially or ethnically diverse.
Future efforts will explore how this mismatch might affect people with diabetes and their health outcomes.
Continuous Glucose Monitoring (CGM)
276-OR: T1D Exchange Multicenter Study—Increasing CGM Adoption in Type 2 Diabetes
While CGMs are commonly used in type 1 diabetes, many people with T2D have less access, especially those who are non-Hispanic Black or Hispanic, with lower incomes, or on public insurance.
Through this study, three endocrinology centers in the T1DX-QI aimed to find strategies that effectively and equitably help more people with T2D use CGMs.
As a result, the average use of CGM increased by 11% over 20 months, from 27% to 38%.
Successful strategies included:
- Making the prescription process easier
- Offering help from tech support staff
- Providing educational materials in different languages
- Using electronic medical records (EMR) to track and encourage CGM use
This shows that focused efforts on equity can help more people with T2D benefit from CGM technology.
1002-P: HbA1c Improvement with the Addition of Continuous Glucose Monitoring to GLP-1 Agonist Therapy in People with Type 2 Diabetes
This study looked at whether using a CGM alongside GLP-1 medications can improve glucose outcomes for people with T2D.
The T1DX-QI reviewed medical records for adults with T2D who had started using a GLP-1 therapy, and some people with T2D who also began using a CGM around the same time.
Key findings:
- GLP-1 medications alone helped lower the average A1C by 0.4%, from 7.3% to 6.9%.
- CGMs alone helped lower the average A1C by 0.5%, from 7.9% to 7.4%.
- The greatest change was seen among people who used a GLP-1 and a CGM, with the average A1C dropping by 0.8%, from 7.9% to 7.1%.
We found that GLP-1 medications and CGMs both improve outcomes for people with T2D, but combining both therapies can lead to even better outcomes.
Mental Health & T1D
1933-LB: Assessing the Financial Strain of Diabetes-Related Costs in Adults with Type 1 Diabetes
This project examined the financial impact of managing T1D and how financial strain might affect health.
Our researchers surveyed over 1,200 adults with T1D in our online registry and found that 54% experienced financial stress due to ongoing costs for medications and care.
Key findings:
- People with higher financial strain had higher A1C levels
- Financial stress was more prevalent among lower-income individuals, those with less education, and among women and non-White participants.
- Higher financial stress was also associated with mental health challenges, like anxiety and depression, and with serious health events like diabetic ketoacidosis (DKA) and severe hypoglycemia.
This study emphasizes that the costs of diabetes care impact not just finances but also health and quality of life, highlighting the need for better insurance coverage, financial support, and mental health resources for people with T1D.
1937-LB: Exploring Associations between Duration of Type 1 Diabetes and Experiences with Anxiety and Depression among Adults in the T1D Exchange Registry
This study looked at the connection between how long someone has had type 1 diabetes (T1D) and their experiences with anxiety and depression.
Researchers surveyed over 1,600 adults with T1D and found that nearly half reported a diagnosis of anxiety (45%) or depression (46%).
Key findings:
- Those newly diagnosed with T1D were more likely to show moderate to severe symptoms of anxiety and depression.
- On average, people with more severe symptoms had been living with T1D for 2 to 4 years less than those with mild or no symptoms.
These findings suggest the need for early mental health support for newly diagnosed individuals to help them manage both their physical and emotional well-being.
1955-LB: Experiences and Preferences for Mental Health Support with Diabetes Health Care Providers among Adults in the T1D Exchange Registry
Many adults with T1D experience anxiety and depression, yet mental health discussions are often missing from their routine care.
Key findings:
- Our survey of over 1,600 adults in the T1D Exchange Registry found that half had been diagnosed with anxiety or depression, but less than half were receiving treatment.
- While most participants didn’t rate their mental health as “poor,” they expressed a clear desire for more support from their diabetes healthcare providers, including conversations about how they’re doing mentally, and referrals to mental health professionals when needed.
These results highlight the need to integrate emotional well-being into routine diabetes care to meet the physical and emotional needs of people with T1D.
1942-LB: Diabetes Distress Screening in Type 1 Diabetes—Are We Meeting Standards in Psychosocial Care?
Routine screening for diabetes distress—the emotional strain of managing T1D–is recommended by national guidelines because it can affect all aspects of a person’s well-being.
We surveyed 57 endocrinology clinics in the T1DX-QI to see how often they screen for diabetes distress.
Key findings:
- 35% of clinics screen for diabetes distress among people with T1D or their caregivers
- Pediatric clinics were more likely to screen than adult clinics.
- Only 16% of the clinics reported screening more than half of their T1D population annually.
These findings underscore the need for better integration of mental health screening in diabetes care to support the emotional well-being of people with diabetes.
Epidemiology of T1D
2105-LB: Limited Readiness for Type 1 Diabetes (T1D) Autoantibody Screening and Metabolic Monitoring among Pediatric and Adult Diabetes Centers in the T1DX-Quality Improvement Collaborative (T1DX-QI)
With new treatments that can potentially delay T1D, there is increased interest in screening for T1D autoantibodies, particularly in family members of people with T1D. We surveyed endocrinology clinics in the T1DX-QI about their current practices.
Key findings:
- While 84% of pediatric clinics screen for T1D, only 39% of adult clinics do.
- Pediatric centers have a greater ability to monitor people who test positive for T1D autoantibodies.
- A key barrier is that insurance and health system limitations hinder screening relatives of people with T1D unless they already see that provider for their own healthcare visits.
The responses to this survey highlight the need for stronger screening and monitoring programs to potentially delay the onset of T1D and improve long-term outcomes for people who are diagnosed with it.
2119-LB – Lifetime Prevalence and Cumulative Burden of Musculoskeletal Conditions in the Type 1 Diabetes Exchange Registry
People with T1D may be more likely to experience certain joint and muscle-related (musculoskeletal) conditions. We looked at T1D Exchange Registry data to see how common these issues are.
Key findings:
- 20% of people reported having two or more musculoskeletal conditions during their lifetime.
- These conditions were more common in women, older adults, and those who had lived with diabetes for a long time.
- People with a higher body mass index were also more likely to have multiple musculoskeletal conditions.
These findings suggest that musculoskeletal issues are a significant but often overlooked part of life with T1D.
