Dessi P Zaharieva1, Franziska K Bishop1, David M Maahs1,2. 1. Division of Endocrinology, Department of Pediatrics, Stanford University, School of Medicine, Stanford. 2. Stanford Diabetes Research Center, Stanford, California, USA.
Abstract
PURPOSE OF REVIEW: The benefits of intensive diabetes management have been established by the Diabetes Control and Complications Trial. However, challenges with optimizing glycemic management in youth with type 1 diabetes (T1D) remain across pediatric clinics in the United States. This article will review our Teamwork, Targets, Technology, and Tight Control (4T) study that implements emerging diabetes technology into clinical practice with a team approach to sustain tight glycemic control from the onset of T1D and beyond to optimize clinical outcomes. RECENT FINDINGS: During the 4T Pilot study and study 1, our team-based approach to intensive target setting, education, and remote data review has led to significant improvements in hemoglobin A1c throughout the first year of T1D diagnosis in youth, as well as family and provider satisfaction. SUMMARY: The next steps include refinement of the current 4T study 1, developing a business case, and broader implementation of the 4T study. In study 2, we are including a more pragmatic cadence of remote data review and disseminating exercise education and activity tracking to both English- and Spanish-speaking families. The overall goal is to create and implement a translatable program that can facilitate better outcomes for pediatric clinics across the USA.
PURPOSE OF REVIEW: The benefits of intensive diabetes management have been established by the Diabetes Control and Complications Trial. However, challenges with optimizing glycemic management in youth with type 1 diabetes (T1D) remain across pediatric clinics in the United States. This article will review our Teamwork, Targets, Technology, and Tight Control (4T) study that implements emerging diabetes technology into clinical practice with a team approach to sustain tight glycemic control from the onset of T1D and beyond to optimize clinical outcomes. RECENT FINDINGS: During the 4T Pilot study and study 1, our team-based approach to intensive target setting, education, and remote data review has led to significant improvements in hemoglobin A1c throughout the first year of T1D diagnosis in youth, as well as family and provider satisfaction. SUMMARY: The next steps include refinement of the current 4T study 1, developing a business case, and broader implementation of the 4T study. In study 2, we are including a more pragmatic cadence of remote data review and disseminating exercise education and activity tracking to both English- and Spanish-speaking families. The overall goal is to create and implement a translatable program that can facilitate better outcomes for pediatric clinics across the USA.
Authors: Sabine E Hofer; Klemens Raile; Elke Fröhlich-Reiterer; Thomas Kapellen; Axel Dost; Joachim Rosenbauer; Jürgen Grulich-Henn; Reinhard W Holl Journal: J Pediatr Date: 2014-08-20 Impact factor: 4.406
Authors: Michael C Riddell; Zoey Li; Roy W Beck; Robin L Gal; Peter G Jacobs; Jessica R Castle; Melanie B Gillingham; Mark Clements; Susana R Patton; Eyal Dassau; Francis J Doyle Iii; Corby K Martin; Peter Calhoun; Michael R Rickels Journal: Diabetes Technol Ther Date: 2021-05 Impact factor: 6.118
Authors: Kirsten Tulchin-Francis; Wilshaw Stevens; Xiangli Gu; Tao Zhang; Heather Roberts; Jean Keller; Dana Dempsey; Justine Borchard; Kelly Jeans; Jonathan VanPelt Journal: J Sport Health Sci Date: 2021-02-28 Impact factor: 7.179
Authors: Ananta Addala; Marie Auzanneau; Kellee Miller; Werner Maier; Nicole Foster; Thomas Kapellen; Ashby Walker; Joachim Rosenbauer; David M Maahs; Reinhard W Holl Journal: Diabetes Care Date: 2020-09-16 Impact factor: 19.112