February 16, 2024

February 2024

Clinical Leadership Committee Meeting

February 16^th, 2024

 

Attendees: Devin Steenkamp, Todd Alonso, Nicole Rioles, Osagie Ebekozien, Holly Hardison, Siham Accacha, Risa Wolf, Patrick Hanley, Yumiko Tsushima, Laura Jacobsen, Lauren Golden, Faisal Malik, Abha Choudhary, Cara Demeterco-Berggren, Noami Fogel, Lauren Golden, Marina Basina, Carol Levy, Allison Smego, Carrie Schulmeister, Mary Pat Gallagher, Tamara Hannon, Anna Netman, David Broome, Daniel DeSalvo, Ruth Weinstock, Vana Raman, Jenise Wong, Joyce Lee, Francesco Vendrame, Neha Vyas, Cynthia Herrick, Nestoras Mathioudakis, Susan Hsieh, Stephanie Crossen, Shideh Majidi, Manu Kamboj, Lily Chao,  Ines Guttmann-Bauman, Grazia Aleppo, Jessica Schmitt

 

Agenda:

• Coordinating Center Reminders
  • Invoicing Reminders
  • Collaborative Team Contact Updates
  • Clinical Interest
• Clinical Leadership Co-Chair Nominations
• Questions from the Collaborative
• T2D Discussion

Coordinating Center Updates:

• Invoicing Reminder
  • Invoices for work performed in 2023 are due now. Deadline for submitting invoice is March 31, 2024. Payments will not be made for invoices received after 3/31/2024
  • Invoices should be sent via email attachment Invoices should be sent via email attachment
    To: Nicole Rioles- nrioles@t1dexchange.org
    • CC: Rene Weathers- rweathers@t1dexchange.org
    • Linda Crasco- linda.crasco@t1dexchange.org
    •  qi@t1dexchange.org
• Co-Chair Nominations
  • New Co-chair terms will begin June 1
    • Use this link to view committees and charters
    • Use this link to submit a nomination

• Contact List Please use this link to view
  • Use this link to submit interest

 

Questions from the Collaborative:

• Name: Mary Pat Gallagher, MD , Has anyone started to use insulin pens in the hospital for new-onset education? We used to have them, but the hospital banned them a few years ago (due to safety concerns on the adult side). We would like to ask for permission to use them in the Children’s Hospital again. Thanks!
  • Great responses from online Q&A

 

• Name: Joyce Lee, MD, I am looking for a template letter for prior authorization to justify Fiasp. The response we got from insurance was that it does not improve glycemic outcomes relative to Humalog novolog. I need some sort of protest letter with citations. Please share if you have them.
  • Chat GBT possibility
  • Daniel DeSalvo: when novolog is covered, fiasp is covered based on network
  • Risa Wolf: For Fiasp – several of our insurances switched to fiasp this year and we have to do the opposite! argue to stick with the usual insulins!
  • Carrie Schulmeister: UC Davis is working on switching to pens only. It is already used on the adult side but not peds. We don’t have data yet but happy to share once we do

 

• Name: Nana-Hawa Yayah Jones, MD, Looking for diabetes peer curriculum and looking to see if anyone has Endo fellow training curriculum in diabetes technology.
  • Risa Wolf: for endo technology training, we set up a series of sessions in the first few weeks of fellowship to sit down with our nurses and go through the different pump systems, their nuances, and then we have a manual of typical scenarios they may encounter with overnight phone calls that we train them on
  • Vana Raman: We have them wear the CGM and pumps
  • Nestoras Mathioudakis: 3 day orientation for hands on in adults
  • Tamara Hannon: diabetes camp is great hands on experience.
  • Group to make a training guide to live online
    • Mary Pat Gallagher and Lauren Golden to facilitate this
  • Daniel DeSalvo: AACE had a great hands-on workshop for diabetes technology, but moved to virtual with COVID and I think staying that way
  • Marina Basina: I do weekly 30 min pre-clinic teaching sessions on the technology for the fellows, repeat some of the talks annually and update them. But no formal curriculum
  • https://www.pantherprogram.org/

 

• Name: Blake Adams, BSN, RN, We are switching to EPIC next year and are currently building our flowsheets and figuring out who will receive access to different the features. The Reports access is being discussed currently and we wondering if other sites utilize this for QI work and who on their team has access to it. Any help you can provide is greatly appreciated!
  • EMR discussion proposal at Collaborative Meeting

 

• Name: Carol Levy, MD, How would canceling Detemir affect patients in your practice

 

• Marina Basina: use in pregnancy patients
• David Broome: Levemir flexpen with shortage supply in mid-January and stopped in 4/1/2024, and vials no longer available on 12/31/2024. I’ve had to switch many to glargine/degludec, etc in a few cases (15-20)
• Laura Jacobsen: I’ve used sparingly in kids on long tube feeds

T2D Discussion:

• What questions does the T1DX-QI Adult and Pediatrics centers want the T2D Collaborative to answer?
  • Devin Steenkamp: area of agreement is technology between both populations
  • Todd Alonso: managing obesity and overweight and defining diabetes diagnosis type
  • Nestoras Mathioudakis: insurance factors
  • Tamara Hannon: There are important barriers to care in T2D in pediatrics. For our center, I worry about this in terms of 1) fewer providers seeing these patients; 2) lack of appt slots; 3) lack of follow through to determine genetics (correctly classifying).
  • Lily Chao: designated T2D slots so they do not get bumped
  • Ruth Weinstock: HCL becoming more common in T2D population
  • Daniel DeSalvo: Pediatric T2D: equity in access to GLP-1/SGLT2i (similar to tech in T1D)

 

Link to Recording: https://us02web.zoom.us/rec/share/DMthp8xrTJpUOQccgvF5mEEFKNeFU1hobr97dzIsBsvYPx-w1carWROf50uOt3hK.20sVmzKLSDtffCjf

Passcode: DzD2=p0A

Next Meeting: Friday April 26^th 11-12pm EST