Thapa, S, Rioles, N, Maahs, D, Crossen, S, Demeterco-Berggren, C, Hood, K, Jacobsen, L, Kamboj, M, Malik, F, Mann E, Scheinker, D, Wolf, R, Ebekozien, O. Diabetes

Introduction and Objective: There is a growing shortage of pediatric endocrinologists, which affects the care available to people with type 1 diabetes’ (PwT1D). We benchmarked provider (physician, nurse practitioner (NP), or physician assistant (PA)) infrastructure for 14,324 PwT1D aged 1-21 years across 9 centers that provided staffing data.

Methods: Centers reported provider staffing data to the T1D Exchange Collaborative while EHR data provided insurance, race/ethnicity, pump/CGM use, and HbA1c metrics. Means, percentages, and ratios were calculated to analyze EMR metrics and provider staffing across centers.

Results: New diagnoses in 2022/2023 averaged 16% of the total PwT1D clinic population across the 9 centers. The clinic population was diverse (70% non-Hispanic White, 11% non-Hispanic Black, 11% Hispanic, 8% Other). Insurance coverage distribution varied widely between centers, with 28% to 58% of PwT1D publicly insured and 2% to 70% privately insured. Mean HbA1c ranged from 7.8% to 9.2% a year after diagnosis. Insulin pump use exceeded 50% in all centers and average CGM use was 78%. On average, there were 216 (99-332) PwT1D and 32 (15-60) new diagnoses per physician (FTE).

Conclusion: These ratios highlight significant workload variation among providers, with some centers facing greater strain due to more cases/fewer providers. This underscores the need for adequate staffing to effectively manage T1D.

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