September 2025 Adult Collaborative Call
September 2025 Adult Collaborative Call
September 25, 11-12:30pm EST
Welcome and Introductions (Nicole Rioles)
Updates from Coordinating Center (Nicole Rioles)
- We are now at 41 Pediatric and 21 Adult Centers. Please find more information on the member website and the QI Portal
The 2025 Annual Survey
- Thank you to those who have already completed the annual survey as we narrow in on our goal of a 100% response rate. Please complete the survey by Friday, October 3rd.
- Measures, publications, and other directives are informed by the responses you submit.
- Please reach out to the qi@t1dexchange.org email with any questions.
Learning Session Updates
- Please register before October 1st and plan to arrive at the hotel by Monday November 10th.
- Collaborative members will present over 60 abstracts (posters and oral presentations) and the Collaborative will publish in the Journal of Diabetes this fall.
- Please share your posters and slides by Friday October 17th. T1DX will cover the printing logistics and costs if you submit your poster by that date.
- Details are in acceptance emails from qi@t1dexchange.org
2026-2028 Measures, next steps
- Collaborative measures for the 2022-2025 period end on 12/31/2025.
- We will share proposed definitions by 10/1 and ask for your feedback by 10/24.
- We will share final definitions by 11/3 with new measures going live on 1/1/2026.
- New Smartsheets will be also shared by 1/1/2026.
- Data reporting for the new period is requested by 3/1/2026 to begin reporting for the 1/1/2026+ period. This data collection process can be simplified for centers that are data mapped.
2023-2025 Data Overview – Adult centers dashboard review (Trevon Wright)
- 21 adult clinics – caring for over 20,000 patients with T1D.
- Trevon shared the Key Driver Diagram.
- We receive data at T1DX either via data mapping or Smartsheets.
- It is important that adult centers share core QI measures. It is the goal for more centers to report this data.
- 68% of adult centers are meeting T1DX-QI goals.
- Please reach out to Trevon (or the QI Team) with more information or any questions about these scorecards.
- We really appreciate your time and effort on QI projects. Thank you!
Clinical center presentation: Northwestern – Jared Friedman, MD and Grazia Aleppo, MD – Screening for Liver Fibrosis in T1D
- SLD: Steatotic Liver Disease.
- MASLD: Metabolic Dysfunction associated with steatotic liver disease.
- MASH: metabolic-dysfunction associated steatohepatitis.
- Details on the progression of MASLD:
- Factors: genetic, environmental, and associations with diabetes and CVD
- Once it reaches the end stages of cirrhosis, there is not reversibility
- There are MASLD risk factors such as obesity and T2D.
- MASLD can also affect diabetes, insulin sensitivity, and insulin resistance.
- The gold standard for screening is a liver biopsy, but it comes with procedural risks.
- FIB-4: A non-invasive screening test allows for initial risk stratification and can identify low, intermediate, high-risk patients and next steps.
There is research around T2D and obesity, but what about patients with T1D?
- 1 in 3 adults with T1D lives with obesity.
- Overview of T1D and MASLD risk.
- They wanted to get a better idea of incidence and next steps.
- Used FIB-4 labs to stratify T1D patients into low and intermediate/high-risk categories.
- What demographic or glycemic variables might be correlated?
- Out of 354 patients screened, 61 fell into the intermediate/high-risk group.
- Significant variables: age (older patients were more at risk), BMI (low risk group had a higher BMI which is contrary to what they anticipated), insurance status (higher risk group were most likely to be publicly insured)
- Results were shared regarding BMI breakdown.
- Conclusions: Individuals with T1D with lower BMI or on public insurance may be at higher risk for an abnormal FIB-4, and therefore at a higher risk for the presence of liver fibrosis. It may be worthwhile to screen for liver fibrosis in individuals with T1D using FIB-4 irrespective of BMI or glycemic status.
- Together we can inform screening guidelines, improve treatment pathways, and preserve the liver health for individuals with T1D.
Discussion points
- FIB-4 scores are abnormal among T1D individuals with lower BMIs.
- Will the role of GLP-1 make a difference for these patients?
- This is a great opportunity to validate these scores across the collaborative.
- Next steps hinge on if there is a relationship or not.
- Conversation around BMI among people with T1D vs people without T1D.
- Why do some people with obesity never develop diabetes?
- Does insulin resistance play a part in all of this rather than BMI?
- Maybe look at insulin dosing per day compared to the FIB-4 scores. There are patients that are overweight but are not insulin resistant.
If anyone have an interest in hyperlipidemia among T1D patients, please reach out.
Next Meeting: Tuesday January 27th 2026 3:30-5:00pm EST
Zoom Recording, password: dX43K%03
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