Research Description
Continuous glucose monitors (CGM) have revolutionized diabetes care and outcomes, but are used much less frequently among children with type 1 diabetes (T1D) from lower income households and those who belong to a racial or ethnic minority. Group clinic visits have been studied in adolescents with T1D and have been shown to improve health outcomes, but they have not been specifically developed to meet the needs of underserved youth with T1D. Implementing group visits that employ collaborative and active discussion will create a visit structure that fosters a sense of community, peer support, and successful use of CGM technology. The study will focus on youth with T1D aged 8-12 years who have not previously used a CGM and 1-2 caretakers who identify as non-Hispanic Black or Latinx. Participants will be randomly assigned to either group visits every 3 months, or traditional individual clinic visits every 3 months over a 12-month period, followed by a 6-month period of observation after return to standard clinical care. The study will evaluate the group visit’s effect on CGM use, diabetes management, and diabetes-related quality of life. Implementing group visits that are specifically targeted to underserved children and their caretakers holds the power to address disparities in T1D by improving diabetes control, emotional well-being, and patient satisfaction.Research Profile
What area of diabetes research does your project cover? What role will this particular project play in preventing, treating and/or curing diabetes?This research will help to address the significant disparities that currently exist in type 1 diabetes care and outcomes by developing shared medical visits to support the uptake and sustained use of diabetes technology among non-Hispanic Black and Latinx youth with public insurance, who historically have been least likely to access these technologies. This multidisciplinary SMA model that involves both youth and caregivers in a communal setting will be easily translated into clinical care in an effort to improve glycemic control, health-related quality of life, access to technologies, and patient satisfaction for all youth living with diabetes.
If a person with diabetes were to ask you how your project will help them in the future, how would you respond?This project will help us to better understand how goals of routine diabetes care can be more adequately addressed and achieved through interactions in the outpatient clinical setting. We expect that the shared medical appointment model will become the preferred method for diabetes follow up for youth and caregivers, giving youth and their families adequate time to meet with various members of the diabetes team and discuss issues and concerns related to diabetes care that are most pressing in day to day life, while also connecting with other families effected by type 1 diabetes.
Why important for you, personally, to become involved in diabetes research? What role will this award play?My experiences as a person living with type 1 diabetes have guided my clinical and research interests in diabetes management and health disparities. After being diagnosed with type 1 diabetes at 9 years old, I became interested in health advocacy and health disparities. Advocating for diabetes research and educating the general public about diabetes fueled my understanding that problems are best approached from the ground up. My curiosity and determination to be involved in change led me to the research labs of multiple diabetes investigators, including Dr. Lawrence Rosenberg, the director of the JDRF Center for Beta-Cell Replacement at McGill and the University of Montreal, and Dr. Daniel Drucker, a senior investigator at the Lunenfeld-Tanenbaum Research Institute at Mount Sinai Hospital in Toronto. I continued to hone my skills in clinical medicine and cultural competency during my Masters of Public Health at Boston University and healthcare work with marginalized populations in the Middle East and India. My time in pediatric residency in Philadelphia strengthened my resolve to continue addressing the social disparities that affect the health and well-being of children. With the support of the Health Disparities Postdoctoral Fellowship Award, I intend to continue using my personal experiences and skills to advance awareness and understanding of health disparities in type 1 diabetes. With the support of my mentor, Dr. Brynn Marks, this award will position me to become an independent investigator poised to direct a research program that promotes health equity and improves care for all people living with type 1 diabetes.
In what direction do you see the future of diabetes research going?It is an exciting time in diabetes research! The progress in diabetes technologies and immune therapies has been astounding! However, until we have a cure, diabetes research must continue to focus on improving our understanding of the modifiable risk factors that influence health outcomes and quality of life among people living with type 1 diabetes. More focus on the underlying factors that influence attitudes and behaviors related to type 1 diabetes care will ensure that these potential barriers can be appropriately addressed so that we can achieve health equity.