Improving Clinical Outcomes in Newly Diagnosed Pediatric Type 1 Diabetes: Teamwork, Targets, Technology, and Tight Control-The 4T Study

Many youth with type 1 diabetes (T1D) do not achieve hemoglobin A1c (HbA1c) targets. The mean HbA1c of youth in the USA is higher than much of the developed world. Mean HbA1c in other nations has been successfully modified following benchmarking and quality improvement methods. In this review, we de...

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Bibliographic Details
Published in:Frontiers in endocrinology (Lausanne) 2020-07, Vol.11, p.360-360
Main Authors: Prahalad, Priya, Zaharieva, Dessi P, Addala, Ananta, New, Christin, Scheinker, David, Desai, Manisha, Hood, Korey K, Maahs, David M
Format: Article
Language:English
Subjects:
Blood Chemical Analysis - methods
Child
continuous glucose monitoring
Diabetes Mellitus, Type 1 - diagnosis
Diabetes Mellitus, Type 1 - therapy
Disease Management
Endocrinology
Glycemic Control - methods
hemoglobin A1c
Humans
insulin pump
Monitoring, Physiologic - methods
pediatrics
Treatment Outcome
type 1 diabetes
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Summary:Many youth with type 1 diabetes (T1D) do not achieve hemoglobin A1c (HbA1c) targets. The mean HbA1c of youth in the USA is higher than much of the developed world. Mean HbA1c in other nations has been successfully modified following benchmarking and quality improvement methods. In this review, we describe the novel 4T approach-teamwork, targets, technology, and tight control-to diabetes management in youth with new-onset T1D. In this program, the diabetes care team (physicians, nurse practitioners, certified diabetes educators, dieticians, social workers, psychologists, and exercise physiologists) work closely to deliver diabetes education from diagnosis. Part of the education curriculum involves early integration of technology, specifically continuous glucose monitoring (CGM), and developing a curriculum around using the CGM to maintain tight control and optimize quality of life.
ISSN:1664-2392
1664-2392
DOI:10.3389/fendo.2020.00360