Our work developing and facilitating research that improves care and life with diabetes is no longer limited to type 1 diabetes (T1D). In 2022, we utilized the same methodologies and systems in the T1D Exchange Quality Improvement Collaborative (T1DX-QI) to launch our type 2 diabetes (T2D) pilot program. 

Our ability to develop and facilitate research that improves care and life with diabetes is no longer limited T1D. In 2022, we utilized the same methodologies and systems in the T1DX-QI to launch our type 2 diabetes (T2D) pilot program. 

The T1DX-QI currently reaches 20,000 patients with T2D — with rapid growth expected throughout 2023. 

Here’s a glimpse of the research conducted in 2022 supporting cardiovascular health in people with T2D at two clinics: Stanford Primary Care and SUNY Endocrinology through the T1DX-QI: 

  • Impact of screening for social determinants of health (SDOH): This program introduced using a screening tool to assess a patient’s SDOH. The incorporation of this tool aimed to ensure HCPs properly address a patient’s SDOH because related issues can directly affect diabetes health — including access to food, dependable transportation, and secure housing.  
  • Increase the prescribing of medications to improve cardiovascular health for eligible patients: Using an established workflow, this program works to increase the number patients eligible to receive cardiovascular-protective medications and education related to those medications. This focused predominantly on SGLT2 inhibitors and GLP-1 agonists — both of which are rapidly becoming first lines of defense in treating T2D. It also included increasing access and medication treatments for statin use for patients with hyperlipidemia and ACE inhibitors and ARBs for patients with hypertension. 

Results: 

  • Within seven months, both sites successfully screened a total of 6,515 patients by implementing the SDOH screening tool into their standard patient workflow.  
  • Depression screenings increased by 34%. 
  • Prescriptions for SGLT-2 inhibitors and GLP-1 agonists increased by 18%. 

What’s next? 

This pilot effort continues through 2024 in five phases: 

Phase 1: Q4-2022 to Q1-2023 

  • Coordinate communication across participating centers to provide centers with analyses regarding the effectiveness of changes and work of their peers 
  • Introduce the Equity 10 Step Framework program to clinics 
  • Develop measures set related to race/ethnicity and device use 

Phase 2: Q2-2023 to Q3-2023 

  • Coach centers in applying an equity framework to patient care, including systematically implementing 10 step framework and evaluating changes in care 
  • Provide evidence-based information on equitable care and tools, forms, and other aids to help with implementation of changes 
  • Develop a repository of interventions for application and testing 
  • Support the Pls in facilitating data collection, internal quality improvement projects, and reporting on time. 

Phase 3: Q3-2023 to Q2-2024 

  • Organize and present conference calls and a strategy session for participating centers virtually or in person 

Phase 4: Q3-2024 to Q4-2024  

  • Develop a Type 2 Diabetes Pilot Change Package that supports new Ql strategies and interventions to improve equitable care in diabetes practices 
  • Submit T2D Health Equity abstract to the ADA Scientific Sessions 
  • Draft T2D Health Equity manuscript intended for 2025 publication 

Our work in type 2 diabetes is only getting started. We anticipate making tremendous progress in facilitating T2D research in 2023!