Demeterco-Berggren, C, Carstairs, K, Cymbaluk, A, Byer-Mendoza, C, McNamara, K, Huber, A., Rompicherla, S, Rioles, N, Odugbesan, O, Ebekozien, O

Introduction: Clinical outcomes continue to be less than ideal for children and adolescents with type 1 diabetes (T1D).
Participation in learning collaboratives can support clinic-clinic benchmarking, improvement projects and use of the real world for system level changes. Targeted quality improvement (QI) projects can have a positive impact on glycemic outcomes.
Methods: We evaluated glycemic outcomes and diabetes technology use from the single center prior and four years after joining T1DX-QI when robust QI programs were implemented to improve CGM and insulin pump access, increase diabetes clinic visit frequency, and to use care navigation outreach for at-risk patients.
We included all patients with available data (n=1,450) aged 2 to18 years with T1D diagnosed for at least 12 months. We compared data from 2018-2020 to 2021-2023 including mean HbA1c, diabetes technology use and the proportion of patients with an HbA1c<7% or >9%.
Results: Baseline data showed mean age of 12.6 ± 3.8 years, male sex was 53.9 %, 45.5 % had public insurance. In the four years after joining the network, CGM use increased from 59.7 % to 90.8 % (p<0.001), insulin pump from 29.1 % to 50.3 % (p<0.001), and mean HbA1c decreased from 8.7± 2% to 8.1± 1.9 % (p<0.001). There was an 11.3 % increase in the percentage of patient who achieved HbA1c<7% (p<0.001) and a 9.2 % decrease in the percentage with HbA1c>9% (p<0.001).
Conclusions: Adopting improvement science and sharing best practices like the T1DX-QI Collaborative can contribute to
increased diabetes technology use and to improvement in glycemic outcomes.
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