Using Quality Improvement Strategies to Advance Early Automated Insulin Delivery Initiation in Pediatric Type 1 Diabetes: A T1D Exchange Multicenter Study
Author Block: ORI ODUGBESAN, NICOLE RIOLES, TIMOTHY R. BOL, TREVON WRIGHT, KRISTINA COSSEN, MING YEH LEE, JULIA BARILLAS, JACOB M. REDEL, HAILEE L. DELSART, SIHAM ACCACHA, STEPHANIE CROSSEN, Boston, MA, Atlanta, GA, Stanford, CA, Great Neck, NY, Kansas City, MO, Cincinnati, OH, New Hyde Park, NY, UC Davis, CA
Introduction and Objective: Studies show that early initiation of automated insulin delivery (AID) systems in children and youth with type 1 diabetes improves HbA1c levels within the first 12 months of diagnosis. However, timely initiation after diagnosis remains suboptimal. We aimed to increase early AID initiation among newly diagnosed T1D patients
Methods: Six pediatric centers from the T1D Exchange Quality Improvement Collaborative utilized quality improvement tools such as process mapping, Ishikawa diagrams, effort impact matrices, and Plan-Do -Study-Act (PDSA) cycles to increase AID initiation among newly diagnosed people with T1D. Retrospective, multicenter descriptive analysis using aggregated data from participating centers was done to compare trends from 2024 and 2025
Results: Across 6 centers, 993 individuals were newly diagnosed in 2024 and 737 in 2025. At baseline AID initiation ranged from 3-8 months across centers and this decreased to 2-4 months in 2025. New-onset AID users who initiated AID within 6 months ranged from 40-84% at baseline and increased to 76%- 90% across centers
Conclusion: Multi-center QI efforts focused around improving clinical processes, patient and provider education, and addressing insurance barriers are effective to promote timely initiation of AID following T1D diagnosis.
