A New Technology-Enabled Care Model for Pediatric Type 1 Diabetes.

Area of Science:

• Endocrinology
• Digital Health
• Pediatric Care

Background:

• Pediatric type 1 diabetes (T1D) care in the U.S. faces challenges including suboptimal patient outcomes and limited access to continuous glucose monitoring (CGM) for publicly insured individuals.
• Current care models often rely on fixed-schedule appointments rather than on-demand interventions, and provider access to CGM data is inefficient.

Purpose of the Study:

• To develop and implement a technology-enabled, telemedicine-based care model for pediatric patients with newly diagnosed T1D.
• To improve access to CGM technology and facilitate timely, data-driven interventions.

Main Methods:

• Development and deployment of the Timely Interventions for Diabetes Excellence (TIDE) platform for automated CGM data analysis and as-needed patient contact.
• Utilizing philanthropic funding to provide CGM access for publicly insured patients.
• Conducting a pilot study (4T study) integrating TIDE with CGM use in new-onset T1D patients.

Main Results:

• The pilot study showed a 0.5%-point reduction in hemoglobin A1c compared to historical controls.
• Provider time spent reviewing patient data decreased by 86% with the TIDE system.
• The TIDE system was expanded to 300 patients and made available as open-source software.

Conclusions:

• The TIDE platform and telemedicine approach represent a successful model for improving pediatric T1D care.
• This model enhances patient outcomes, increases provider efficiency, and improves access to essential diabetes technology.
• Future plans include scaling the TIDE system to support approximately 1,000 patients and integrating data from additional sensors.