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. 2021 Jul;39(3):264-271.
doi: 10.2337/cd21-0026.

Multi-Clinic Quality Improvement Initiative Increases Continuous Glucose Monitoring Use Among Adolescents and Young Adults With Type 1 Diabetes

Priya Prahalad  1   2 , Osagie Ebekozien  3 , G Todd Alonso  4 , Mark Clements  5 , Sarah Corathers  6 , Daniel DeSalvo  7 , Marisa Desimone  8 , Joyce M Lee  9 , Ilona Lorincz  10 , Ryan McDonough  5 , Shideh Majidi  4 , Ori Odugbesan  3 , Kathryn Obrynba  11 , Nicole Rioles  3 , Manmohan Kamboj  11 , Nana-Hawa Yayah Jones  6 , David M Maahs  1   2 ; T1D Exchange Quality Improvement Collaborative Study Group
Affiliations

Multi-Clinic Quality Improvement Initiative Increases Continuous Glucose Monitoring Use Among Adolescents and Young Adults With Type 1 Diabetes

Priya Prahalad et al. Clin Diabetes. 2021 Jul.

Abstract

Continuous glucose monitoring (CGM) use is associated with improved A1C outcomes and quality of life in adolescents and young adults with diabetes; however, CGM uptake is low. This article reports on a quality improvement (QI) initiative of the T1D Exchange Quality Improvement Collaborative to increase CGM use among patients in this age-group. Ten centers participated in developing a key driver diagram and center-specific interventions that resulted in an increase in CGM use from 34 to 55% in adolescents and young adults over 19-22 months. Sites that performed QI tests of change and documented their interventions had the highest increases in CGM uptake, demonstrating that QI methodology and sharing of learnings can increase CGM uptake.

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Conflict of interest statement

O.E. is a compensated Health Equity Advisory Board member for Medtronic Diabetes and serves as principal investigator for investigator-led projects sponsored by Abbott, Eli Lilly, Insulet, and Medtronic. M.C. has consulting arrangements with Eli Lilly and Medtronic, is an employee (chief medical officer) of Glooko, and has received research support from Abbott Diabetes Care and Dexcom and travel support from Intrexon and Provention Bio. J.M.L. is on a medical advisory board for GoodRx. D.M.M. has received research support from the Helmsley Charitable Trust, JDRF, the National Institutes of Health, and the National Science Foundation; his institution has received research support from Bigfoot Biomedical, Dexcom, Insulet, Medtronic, Roche, and Tandem; and he has been a consultant for Abbott, Aditxt, Dompe, Eli Lilly, the Helmsley Charitable Trust, Insulet, Medtronic, Novo Nordisk, and Sanofi. No other potential conflicts of interest relevant to this article were reported.

Figures

FIGURE 1
FIGURE 1
Key driver diagram for increasing CGM uptake across the T1DX-QI collaborative. The secondary drivers are interventions to support the key drivers.
FIGURE 2
FIGURE 2
Control chart of CGM use among 12- to 26-year-old youths from all 10 participating sites in the T1DX-QI collaborative. CGM use increased from 34% baseline to 55% in 20 months after testing various interventions. Dashed lines are control lines, the solid line represents the mean. Dem, denominator; Num, numerator.
See this image and copyright information in PMC

References

    1. Diabetes Control and Complications Trial Research Group; Nathan DM, Genuth S, Lachin J, et al. . The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin-dependent diabetes mellitus. N Engl J Med 1993;329:977–986 - PubMed
    1. Diabetes Control and Complications Trial Research Group . Effect of intensive diabetes treatment on the development and progression of long-term complications in adolescents with insulin-dependent diabetes mellitus: Diabetes Control and Complications Trial. J Pediatr 1994;125:177–188 - PubMed
    1. American Diabetes Association . 13. Children and adolescents: Standards of Medical Care in Diabetes—2020. Diabetes Care 2020;43(Suppl. 1):S163–S182 - PubMed
    1. Foster NC, Beck RW, Miller KM, et al. . State of type 1 diabetes management and outcomes from the T1D Exchange in 2016–2018. Diabetes Technol Ther 2019;21:66–72 - PMC - PubMed
    1. Miller KM, Foster NC, Beck RW, et al. .; T1D Exchange Clinic Network . Current state of type 1 diabetes treatment in the U.S.: updated data from the T1D Exchange clinic registry. Diabetes Care 2015;38:971–978 - PubMed