September 2025 Adult Collaborative Call

September 2025 Adult Collaborative Call 

September 25, 11-12:30pm EST 

Sept Adult Call FINAL SLIDES 

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