Author Block: ORI ODUGBESAN, TIMOTHY R. BOL, TREVON WRIGHT, HALIS K. AKTURK, KAI JONES, GRAZIA ALEPPO, JUSTIN MATHEW, MARGARET ZUPA, CAROL LEVY, EMMA EDMONDSON, DAVID BROOME, FARAHNAZ JOARDER, MARINA BASINA, MALEK EL MUAYED, NICOLE RIOLES, NESTORAS MATHIOUDAKIS, Boston, MA, Aurora, CO, St Louis, MO, Chicago, IL, Bronx, NY, Pittsburg, PA, New York, NY, Philadelphia, PA, Ann Arbor, MI, Portland, OR, Stanford, CA, Syracuse, NY, Baltimore, MD
Introduction and Objective: Advances in diabetes technology, including continuous glucose monitors (CGM) and automated insulin delivery systems (AID), have demonstrated significant benefits for glycemic outcomes and quality of life. Real-world adoption among adults with diabetes remains variable. The T1D Exchange Quality Improvement Collaborative (T1DX-QI) supports participating centers in implementing system-level interventions to increase access to diabetes technology
Methods: Participating centers applied QI principles including the Ishikawa diagram, process map, effort/impact matrix tool, and Plan - Do - Study - Act cycles to test and expand interventions. Participating centers share monthly aggregate data with the coordinating center via a secure web portal. Aggregated data from January 2023 to May 2025 were analyzed. Statistical process control charts were used to assess trends in CGM use and AID use over time.
Results: Adult CGM use increased from 69% to 77%, demonstrating sustained improvement and a shift in the mean. Adult AID use increased from 38% to 45%. Both CGM and AID utilization showed upward shifts, with multiple centers exceeding previous baselines
Conclusion: Across the T1DX-QI Collaborative, CGM and AID use among adults has increased substantially over the past two years. These improvements align with coordinated QI efforts focused on workflow redesign, patient engagement, and reducing access barriers.
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