<b>Increasing Continuous Glucose Monitoring Use for Non-Hispanic Black and Hispanic People With Type 1 Diabetes: Results From the T1D Exchange Quality Improvement Collaborative Equity Study</b>

Despite the benefits of continuous glucose monitoring (CGM), there is lower use of this technology among Non-Hispanic Black and Hispanic people with type 1 diabetes compared to their non-Hispanic White counterparts. The T1D Exchange Quality Improvement Collaborative recruited five endocrinology centers to pilot an equity-focused quality improvement (QI) study to reduce racial inequities in CGM use. The centers used rapid QI cycles to test and expand interventions such as provider bias training, translation of CGM materials, provision of CGM education in multiple languages, screening for social determinants of health, and shared decision-making. After implementation of these interventions, median CGM use increased by 7% in non-Hispanic White, 12% in non-Hispanic Black, and 15% in Hispanic people with type 1 diabetes. The gap between non-Hispanic White and non-Hispanic Black patients decreased by 5%, and the gap between non-Hispanic White and Hispanic patients decreased by 8%.</p

<b>Understanding Providers’ Readiness and Attitudes Toward Autoantibody Screening: A Mixed-Methods Study</b>

Screening for autoantibodies associated with type 1 diabetes can identify people most at risk for progressing to clinical type 1 diabetes and can provide an opportunity for early intervention. Drawbacks and barriers to screening exist, and concerns arise, as methods for disease prevention are limited and no cure exists today. The availability of novel treatment options such as teplizumab to delay progression to clinical type 1 diabetes in high-risk individuals has led to the reassessment of screening programs. This study explored awareness, readiness, and attitudes of endocrinology providers toward type 1 diabetes autoantibody screening.</p

Demographic, clinical, management and outcome characteristics of 8,004 young children with type 1 diabetes

Objective: To compare demographic, clinical, and therapeutic characteristics of children with type 1 diabetes aged <6 years across three international registries: Diabetes Prospective Follow-up Registry (DPV, Europe), T1D Exchange Quality Improvement Network (T1DX-QI, USA) and Australasian Diabetes Data Network (ADDN, Australasia). Research Design and Methods: Analysis of 2019-2021 prospective registry data from 8,004 children were compared. Results: Mean±SD age at diabetes diagnosis was 3.2±1.4 (DPV, ADDN), and 3.7±1.8 years (T1DX-QI). Diabetes duration was 1.4±1.3 (DPV), 1.4±1.6 (T1DX-QI), and 1.5±1.3 years (ADDN). and BMI z scores were in the overweight range in 36.2% (DPV), 41.8% (T1DX-QI), and 50.0% (ADDN). and Mean±SD HbA1c varied between registries: DPV 7.3±0.9% (56±10mmol/mol, T1DX-QI 8.0±1.4% (64±16mmol/mol), ADDN 7.7±1.2% (61±13mmol/mol). Overall, 37.5% of children achieved target HbA1c of <7.0% (53mmol/mol); 43.6% in DPV, 25.5% in T1DX-QI and 27.5% in ADDN. Use of diabetes technologies varied between registries for use of insulin pump: DPV 86.6%, T1DX 46.6%, and ADDN 39.2%; and continuous glucose monitoring (CGM): DPV 85.1%, T1DX-QI 57.6%, and ADDN 70.5%. Use of hybrid closed loop (HCL) systems was uncommon (0.5% (ADDN) to 6.9% (DPV)). Conclusions: Across three major registries, over half of children aged <6 years did not achieve target HbA1c of <7.0% (53 mmol/mol). CGM was used by most participants, while insulin pump use varied across registries and HCL use was rare. The differences seen in glycemia and use of diabetes technologies between registries requires further investigation to determine potential contributing factors and areas to target to improve the care of this vulnerable group.</p

Facilitators and Barriers to Smart Insulin Pen Use: A Mixed-Method Study of Multidisciplinary Stakeholders From Diabetes Teams in the United States

This study sought to identify barriers and facilitators to successful smart insulin pen (SIP) use and gauge prescribing practices and integration into clinical practice by assessing provider and care team perspectives at participating endocrinology clinics within the T1D Exchange Quality Improvement Collaborative. The identified provider-related, patient-related, and clinic- and operational-level barriers and facilitators varied based on clinic knowledge, capacity, and resources. High-impact barriers included insurance coverage and prescribing processes; high-impact facilitators included improved diabetes clinic visit quality and use of SIPs as an alternative to insulin pump therapy. Findings indicated the need for provider and care team education and training on proper SIP features, use, and prescribing