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This year has been an exciting time of major strides for the T1D Exchange Collaborative, keeping current issues at the forefront of clinical real-world care. T1DX will continue to search for new ways to drive change for patients and their families, using novel QI methodology, stakeholder engagement, and data-driven approaches. Future directions may include diabetes technology data integration in the electronic medical record, new psychosocial care models that address highly prevalent psychological issues in people with T1D, and shared decision aids that promote patient-centered care in diabetes.