April 2026 Combined Adult and Pediatric Call

April 14, 2026 Combined Call Meeting Minutes 

Participants: Andrea Mucci, Siham Accacha, Manu Kamboj, Janine Sanchez, Jason Ng, Jordan Ross, Amy Ohmer, Zunera Tariq, Yllka Valdez, Blake Adams, Tami Hannon, Meghan Muir, Carla Demeterco-Berggren, Jodi Nagelberg, Jack Timm, Anna Cymbaluk, Gwendolyne Jack, Amy Poetker, Emma Mason, Joe Erardi, Lauren Golden, Emma Edmondson, Donna Eng, David Schwartz, Shideh Majidi, Wendy Izzo, Andrew Welch, Abha Choudhary, Liz Mann, David Lam, Aashna Shah, Lily Chao, Preneet Brar, Nes Mathioudakis, Jeniece Ilkowitz, Kimberly McNamara, Nana Jones, Lydia Holly, Sarah Corathers, Katie Noland, Alissa Roberts, Alissa Guarneri, Mary Farkouh, Dan DeSalvo, Grace Nelson, Alyssa Rowe, Monica Mortenson, Naomi Fogel, Berit Bagley, Adena Goldstein, Farahnaz Joarder, Kimberly Vidmar, Carol Levy, Stephanie Ogburn, Renee Thompson, Jessica Schmitt, Brian Miyazaki, Ryan Tweet, Isabel Reckson, Deborah Plante, Lori Benzoni, Sheila Dennehy, Mary Pat Gallagher, Becca Campbell, Allison Smego, Ahsan Uddin, Inas Thomas, Amy Grant, Puja Singh, Risa Wolf, Katie Craft, Evelyn Fronczyk, Annie Uhing, Selorm Dei-Tutu, Francesco Vendrame, Monica Bianco, Veronica Figueredo, Andrea Huber, Mili Vakharia, Andrew Lavik, Kim Rossi, Amy Grant, Julia Blanchette, Meenal Gupta, Amanda Perkins, Ryan McDonough, Carrie Schulmeister, Rachael Lee, Prasanth Surampudi, Ines Guttmann-Bauman, Brooke Myers, Becky Sidberry, Alex Siller, Meghan Muir, Jenise Wong, Ori Odugbesan, Dhruvi Vora, Saketh Rompicherla, Don Buckingham, James Dawson, Claire Rainey, Tim Bol, Alyssa Cabrera, Nicole Rioles 

Slide deck and Recording (passcode: KRD8uab!) 

Welcome and Agenda Overview (Nicole Rioles, MA) 

Suggest a Topic for the 2026 Annual Survey  

• We are collecting annual survey topic proposals through May 1, 2026 

• To submit a topic, email qi@t1dexchange.org and cc nrioles@t1dexchange.org and crainey@t1dexchange.org 

Learning Session 2026 Call for Abstracts through July 31, 2026 

• We encourage your teams to submit an abstract on your current QI projects! 

• Call for Abstracts 

• 2026 Learning Session Page 

Engagement Survey 

• This survey will be used to evaluate engagement opportunities based on your level of participation and the value that they provide to your center. We appreciate your feedback so that we can make improvements. 

Publications  

• Overview of 2026 publications to date (see slides for those details) 

• Please reach out to crainey@t1dexchange.org with high IF journal ideas  

ADA Posters and Presentations 

• The QI Team shared a poster template with first authors by 4/17/26. 

• First authors, please complete first draft by Monday, May 4th and share with Coordinating Center at QI@t1dexchange.org 

• Co-authors, please share feedback by Monday, May 11th 

• First authors, please share back final draft by Friday, May 15th 

• ADA deadline for poster printing is Friday, May 22nd 

ADA Breakfast, Sunday June 7th from 7:00 – 8:30 am 

• We’d love to see you in NOLA! Please RSVP to the T1DX ADA Breakfast using this link 

Updated 2026-2028 Measures and Data Spec (Alyssa Cabrera, MPH) 

• Overview 

• • A summary of changes from the previous measurement period to the current period is available on the member website.  

• Key Measure Updates 

• • High-level updates to measures were reviewed.  

• • Correlation between GMI and A1C study discussion  

• Data Portal Changes 

• • For future access requests, please submit a request through the RWE team.  

• Version Updates and Communication 

• • An additional announcement will be sent once version 04.0 becomes active. 

• • Updates will be shared with IT contacts and PIs; PIs are encouraged to coordinate internally with their IT teams to ensure clarity and next steps.  

• Timeline 

• • Draft version of the v040 data spec expected in May, allowing IT teams to begin updates and data mapping in advance.  

• • Refer to the Overview of Changes documents to ensure that your data is  mapped correctly moving forward 

• • The new measures will be published on the portal after we ensure that we’re receiving files in the new format  

University of Cincinnati Presentation: Transitions of Care from Pediatric to Adult Endocrinology in Diabetes: An Adult Endocrinology Perspective (Andrew Welch, DO) 

• Pediatric care model has a lot of different resources that people interact with on a regular basis 

• Make a system that makes patients better connected and have better transitions 

• DIabetes Resilience in Emerging adult Clinical Transitions (DIRECT Clinic) 

• 1st visit  

• • 30-minute appt 

• • All prescription medications are ordered by adult provider during visit 

• • Intro to members of care team  

• Follow up visits 

• • Simultaneous scheduling of 3-4 follow up appts when scheduling first appt or at first appt  

• • Tracking transitions 

• • Work on reaching out to those who don’t have a follow up scheduled  

• DIRECT cohort demographics:  

• • N=78 

• • Age=mean 22.8 years (19-28) 

• • Last HbA1c: mean 7.2% (6.0-11.4%) 

• • 95% T1D 

• • 93% from CCHCM Endocrinology 

• Many outliers who were lost during transition for various reasons  

• Learned that it is important to not cut off patients from peds providers completely  

• Future directions  

• • Registry 

• • Virtual visit options  

• • Checklist approach to transition education at first visit 

• • More Staffing support needed 

• Practical transition tips  

• • Make time between last peds visit and adult referral either 0 days or negative days  

• • Transition conversations happen sooner, alternate visits – open line of communication with another provider  

• Please email welchaw@ucmail.uc.edu with questions 

 

University of Tennessee Health Science Center Presentation: Implementation of Type 1 Diabetes Adult Transition Process (Jordan Ross, MD) 

• Aim: increase patients completing a transition program, increase percentage of patients who successfully transition to adult care 

• Internal referral (no younger than 15 years)  

• Visit every 6 months – alternating quarterly visits with the adolescent’s primary endocrinologist 

• Orientation to clinic with booklet  

• Transition visit checklist  

• • Highlights key tasks and educational topics to cover throughout the transitional period  

• • Updated throughout the transition period 

• Overview of fishbone diagram, process map, registry, etc.  

• Next Steps 

• • Build a transition clinic note template in Epic 

• • Build a transition checklist SmartForm in Epic 

• • Transfer the registry from Excel to Epic 

• • Develop a graduation packet to send with each referral 

• • Build team in order to look at patients who have been lost to follow-up 

• Discussion 

• • Purposeful use of positive and thoughtful language: “graduation from pediatric care”, “adult receivership”, “consistent care” 

• • For anyone interested in Readdy2.0 https://redcap.link/READDY2.0  

• Please email jross27@uthsc.edu with questions

Texas Children’s Presentation: Predicting DKA Risk and Driving Interventions in Children with Type 1 Diabetes (David D. Schwartz, PhD, ABPP; Selorm A. Dei-Tutu, MD, MPH) 

• Problem: too many children with DKA and recurrent DKA episodes  

• Goal: reduce or prevent DKA in children with T1DM 

• Population 

• • Aim: identify patients at risk for DKA and intervene preventively  

• • • Clinical judgement – misses many patients 

• • • Need system for screening/surveillance 

• • • Automatic risk prediction tool: The Risk Index for Diabetic Ketoacidosis (RI-DKA) 

• • Predictors identified based on lit review and high-risk CPT 

• • Had to be able to be extracted automatically from EMR  

• • Final Model and AUC 

• • Risk score and risk categories  

• • RI-DKA implementation into EMR 

• • Clinical leverage of RI-DKA score  

• Team players and desired outcomes 

• • Team: QI Team, social workers, nurse coordinator 

• • Outcomes: reduce DKA, improve A1c, improve technology use 

• Standardize workflow and documentation  

• Track outcomes (REACH scorecard, sustain DKA percentage at <35%, sustain A1C>12% at <35%, increase CGM use to 80% and pump use to 50%) 

• Lessons learned 

• • Automated risk score allows doe objective way to identify patients who need the most help without relying on staff input 

• • Specific, well-laid out documentation has been key 

• • Leveraging teamwork is critical 

• Next Steps 

• • External validation of RI-DKA through the T1DX-QI 

• • Incorporate psychosocial data (SDOH, PHQ-9) into version 2.0 

• • Consider qualitative outcomes via interviews with REACH cohort participants 

• • Targeting interventions at moderate risk group 

• Please email deitutu@bcm.edu or ddschwar@bcm.edu with questions 

 

Next Adult Call: Tuesday July 21st 3:30-5pm EST  

Next Peds Call: Thursday July 23rd 11-12:30pm EST