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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Main Authors:	Priya Prahalad, Dessi P. Zaharieva, Ananta Addala, Christin New, David Scheinker, Manisha Desai, Korey K. Hood, David M. Maahs
Format:	Article
Language:	English
Published:	Frontiers Media S.A. 2020-07-01
Series:	Frontiers in Endocrinology
Subjects:	type 1 diabetes pediatrics insulin pump continuous glucose monitoring hemoglobin A1c
Online Access:	https://www.frontiersin.org/article/10.3389/fendo.2020.00360/full

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spelling	doaj-8035c92156c1488bbc85b3a8c54029e02020-11-25T02:50:37ZengFrontiers Media S.A.Frontiers in Endocrinology1664-23922020-07-011110.3389/fendo.2020.00360533078Improving Clinical Outcomes in Newly Diagnosed Pediatric Type 1 Diabetes: Teamwork, Targets, Technology, and Tight Control—The 4T StudyPriya Prahalad0Dessi P. Zaharieva1Ananta Addala2Christin New3David Scheinker4David Scheinker5Manisha Desai6Manisha Desai7Korey K. Hood8Korey K. Hood9David M. Maahs10David M. Maahs11Division of Endocrinology, Department of Pediatrics, Stanford University, Stanford, CA, United StatesDivision of Endocrinology, Department of Pediatrics, Stanford University, Stanford, CA, United StatesDivision of Endocrinology, Department of Pediatrics, Stanford University, Stanford, CA, United StatesDivision of Endocrinology, Department of Pediatrics, Stanford University, Stanford, CA, United StatesDivision of Endocrinology, Department of Pediatrics, Stanford University, Stanford, CA, United StatesDepartment of Management Science and Engineering, Stanford University, Stanford, CA, United StatesQuantitative Sciences Unit, Division of Biomedical Informatics Research, Stanford University, Stanford, CA, United StatesStanford Diabetes Research Center, Stanford, CA, United StatesDivision of Endocrinology, Department of Pediatrics, Stanford University, Stanford, CA, United StatesStanford Diabetes Research Center, Stanford, CA, United StatesDivision of Endocrinology, Department of Pediatrics, Stanford University, Stanford, CA, United StatesStanford Diabetes Research Center, Stanford, CA, United StatesMany 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.https://www.frontiersin.org/article/10.3389/fendo.2020.00360/fulltype 1 diabetespediatricsinsulin pumpcontinuous glucose monitoringhemoglobin A1c
collection	DOAJ
language	English
format	Article
sources	DOAJ
author	Priya Prahalad Dessi P. Zaharieva Ananta Addala Christin New David Scheinker David Scheinker Manisha Desai Manisha Desai Korey K. Hood Korey K. Hood David M. Maahs David M. Maahs
spellingShingle	Priya Prahalad Dessi P. Zaharieva Ananta Addala Christin New David Scheinker David Scheinker Manisha Desai Manisha Desai Korey K. Hood Korey K. Hood David M. Maahs David M. Maahs Improving Clinical Outcomes in Newly Diagnosed Pediatric Type 1 Diabetes: Teamwork, Targets, Technology, and Tight Control—The 4T Study Frontiers in Endocrinology type 1 diabetes pediatrics insulin pump continuous glucose monitoring hemoglobin A1c
author_facet	Priya Prahalad Dessi P. Zaharieva Ananta Addala Christin New David Scheinker David Scheinker Manisha Desai Manisha Desai Korey K. Hood Korey K. Hood David M. Maahs David M. Maahs
author_sort	Priya Prahalad
title	Improving Clinical Outcomes in Newly Diagnosed Pediatric Type 1 Diabetes: Teamwork, Targets, Technology, and Tight Control—The 4T Study
title_short	Improving Clinical Outcomes in Newly Diagnosed Pediatric Type 1 Diabetes: Teamwork, Targets, Technology, and Tight Control—The 4T Study
title_full	Improving Clinical Outcomes in Newly Diagnosed Pediatric Type 1 Diabetes: Teamwork, Targets, Technology, and Tight Control—The 4T Study
title_fullStr	Improving Clinical Outcomes in Newly Diagnosed Pediatric Type 1 Diabetes: Teamwork, Targets, Technology, and Tight Control—The 4T Study
title_full_unstemmed	Improving Clinical Outcomes in Newly Diagnosed Pediatric Type 1 Diabetes: Teamwork, Targets, Technology, and Tight Control—The 4T Study
title_sort	improving clinical outcomes in newly diagnosed pediatric type 1 diabetes: teamwork, targets, technology, and tight control—the 4t study
publisher	Frontiers Media S.A.
series	Frontiers in Endocrinology
issn	1664-2392
publishDate	2020-07-01
description	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.
topic	type 1 diabetes pediatrics insulin pump continuous glucose monitoring hemoglobin A1c
url	https://www.frontiersin.org/article/10.3389/fendo.2020.00360/full
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Improving Clinical Outcomes in Newly Diagnosed Pediatric Type 1 Diabetes: Teamwork, Targets, Technology, and Tight Control—The 4T Study

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