Devin Steenkamp is an endocrinologist at Boston Medical Center and Assistant Professor of Endocrinology, Diabetes, Nutrition, and Weight Management at Boston University Chobanian and Avedisian School of Medicine. Dr. Steenkamp is the Director of the Clinical Diabetes Program at Boston Medical Center and serves as the T1D Exchange Quality Improvement Collaborative (T1DX-QI) site PI for adult T1D endocrinology at Boston Medical Center.

Interview with Devin Steenkamp, MD

In this interview, Dr. Steenkamp discusses his involvement with the T1DX-QI as a diabetologist and physician-scientist whose clinical practice and research are focused on the use of diabetes technology in underserved populations.

The T1DX-QI was established in 2016 — with the support of The Leona M. and Harry B. Helmsley Charitable Trust — to refine best practices and improve the quality of care and outcomes for individuals living with T1D. Growth has been tremendous, with 62 endocrine clinics from across the U.S. participating in the Collaborative.

Fueled by top leaders in diabetes care, the T1DX-QI has become an engine of innovation and inspiration. By engaging with its shared, data-driven, and systematic methods, clinics have seen unprecedented success in their approach to diabetes management.

With members working closely to identify gaps in care, discover and refine best practices, and share research — the process has become knowledge-sharing at its very best. While collated data gives clinics a clear sense of “where they are,” it also demonstrates “where they can be” by applying shared, evidence-based methods for improving care.

 

 

What brought you to endocrinology? Who has influenced you the most?

“After graduating from medical school at the University of Pretoria in South Africa, I worked in a private practice as a family doctor in Saskatchewan, Canada for a few years,” said Steenkamp. “I decided to work in rural Canada because I wanted to be a rugged, individualistic clinician that could deliver babies, suture stuff, and be an overall rural doc.”

“Diabetes care wasn’t something I expected, but by the time I left, it was about 70% of my practice. I really enjoyed working with these patients, and I knew I wanted to be an endocrinologist — which certainly isn’t a normal trajectory,” explained Steenkamp. “So, I came to the U.S. to do my residency with the intent to be an endocrinologist, more specifically, a diabetologist.”

“In my second year of endocrinology fellowship, I had the opportunity to work with another South African endocrinologist, Howard Wolpert, in the world-renowned diabetes technology program he established at Joslin. Howard has been a wonderful mentor, and he and Dr. Marie McDonnell, who was leading the diabetes program at BMC at the time, encouraged me to do something really difficult — to set up a technology program in an underserved, safety net hospital,” said Steenkamp.

“It’s taken a long time to make significant inroads, but I know this needed to happen, and the tech program has been the ‘main baby’ I’ve carried during my 10 years at BMC post-fellowship,” said Steenkamp, who, in addition to his involvement in scientific studies and various trials related to underserved T1D populations, provides in-clinic care for many adults with T1D.

Steenkamp explained, “While some people ask if I’m in endocrinology because of my wife, who has lived with diabetes for 27 years, I honestly don’t think that had much to do with my interest,” said Steenkamp. “However, witnessing her self-sufficiency and discipline, due in part to the grounding, support, and foundational education she received soon after diagnosis, has helped to frame the way I think about diabetes and shape my approach to practice.”

 

Can you describe your role as an endocrinologist focused on T1D care?

“As a diabetologist, I help people to live their best lives with a condition that they didn’t deserve to get and need to learn how to manage — that’s ultimately what I do,” said Steenkamp.

“Pretty early on, I realized I didn’t have a traditional physician role, in terms of how we’re trained in adult medicine — and I think that’s what attracted me to the field,” said Steenkamp. “I see myself as a ‘health coach’ who applies physiology and pharmacology to the behavior and lived experience of someone with diabetes.”

 

T1DX-QI and BMC

“My initial interest in T1DX-QI was largely to have data that we could react to internally,” said Steenkamp, who explained, “Data helps to inform our practice, take away some biases, and keep us moving along.”

“Until joining in 2021, I wasn’t aware of how high our CGM use rates were, and it was validating to see we were doing well there. I had no idea we were leaders in this space because it’s just what we do every day.”

That said, “One of the most phenomenal things about T1DX-QI is the collaborative nature of the group,” said Steenkamp, who explained that in academic medicine, it’s unusual for people to work together as freely.

“We’re all struggling with similar questions, and it creates an opportunity for us to speak directly. While we have different environments and patient populations, information sharing has been a major benefit for BMC,” said Steenkamp. “Having a group of people pushing forward together is invigorating — it motivates everyone.”

“T1DX-QI gives us an opportunity to provide some perspective and leadership — and to recognize areas we can improve upon. Even if it’s a slow process and every center has different challenges, ultimately, we help to move care forward for the community at large,” said Steenkamp.

 

What’s your drive behind diabetes research?

“If someone were to define what we do externally, it would be that at BMC, we’re one of a few places in the country that are — at a high level and a high volume — using diabetes technology in minoritized and underserved adults with T1D,” said Steenkamp.

“Over 80% of our adult patients with T1D are using CGMs, which is unusual in a safety net environment,” explained Steenkamp. “It’s taken a long time and a lot of hard work to get our program to this place.”

“Being that we’re particularly good at technology, it’s our focus and an area that we contribute to research,” said Steenkamp, who is working alongside Dr. Wolpert and with collaborators at Albert Einstein School of Medicine and Northwestern Feinberg School of Medicine on an NIH funded study that kicked off in January 2024 to test three automated insulin delivery pump systems in adults with T1D: the Insulet, OmniPod 5, and Tandem t:slim X2 with Control-IQ.

“We’re randomizing participants who are naive to closed loop/AID systems with the intent to understand the implications of these systems, user experiences, and the nuances that shape device choices for different populations,” explained Steenkamp.

“Our aim isn’t to say, ‘one pump is better than the other,’ it’s more about understanding system implications, what patients have to think about, and why someone would select one device instead of another,” said Steenkamp, who also participates in industry studies with various diabetes technologies, including AID systems in underserved people living with diabetes.

 

What’s your hope for the future of diabetes care?

“I think we need more excitement and capacity for people to come into endocrinology. That’s top of mind for me, especially with how quickly the field is moving forward and the complexity and excitement that comes with the technology,” said Steenkamp, a devoted mentor to endocrinology trainees and junior faculty.

“This may not be at the forefront of everyone’s mind, but from the patient’s perspective, how they’re going to get the quality care they need — at the level they need — worries me. There are simply not enough endocrinologists in the pipeline,” said Steenkamp.

“What type of diabetes care will my daughter, who was diagnosed with diabetes last summer, receive when she’s an adult? Will it be from an endocrinologist who not only understands the latest advances in the field but also ‘gets her’ as a person and values what’s important to her?”

“That’s why I’m concerned about developing the next generation of endocrinologists,” said Steenkamp. “As a fellow, I only had one patient with T1D using a device, and I had to seek out opportunities at a different institute to learn— and I think that’s a problem we’re beginning to address in the field with more learning opportunities for trainees to develop the knowledge and skill set needed to succeed.”

“Prescribing a pump doesn’t mean that a person is going to do well. Success is found in how technology is applied to a person’s life. That’s why mentoring is a big part of what I still do today.”

 

What do you like to do outside of work?

Outside of work, Dr. Steenkamp enjoys spending time with his family and as a musician, playing the saxophone, piano, and guitar. You’ll likely find him in an ice hockey rink or another sports venue, supporting his kids’ athletic endeavors or cheering for his South African rugby team.