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Teamwork, Targets, Technology, and Tight Control in Newly Diagnosed Pediatric T1D: 4T Study

Award Number: R18DK122422
ORGANIZATION: NATIONAL INSTITUTE OF DIABETES & DIGESTIVE & KIDNEY DISEASES
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: KDA (KNOWLEDGE/DEVELOPMENT/APPLICATION)

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Teamwork, Targets, Technology, and Tight Control in Newly Diagnosed Pediatric T1D: 4T Study - Project Summary: The goal of the 4T study is to implement proven methods and emerging diabetes technology into our clinical practice to sustain tight glucose control from the onset of type 1 diabetes (T1D) and optimize patient reported and psychosocial outcomes. We will define a program (4T---Teamwork, Targets, Technology and Tight Control) translatable to Pediatric Diabetes clinics in the United States that reduces HbA1c and T1D burden and improves patient well-being. In response to the R18 mechanism, we have designed a pragmatic approach to study a re-designed diabetes education and care delivery program in newly diagnosed Pediatric T1D patients. The primary outcome will be to implement 4T education and care in newly diagnosed T1D patients to reduce the rise in HbA1c observed 6 months post-diagnosis. We will compare results to historic data from our clinic and to contemporaneous new onset HbA1c data in the USA and internationally. Our secondary aims are to refine a systematic, pragmatic approach to monitoring longitudinal Patient Reported Outcomes and Psychosocial Outcomes and to develop and test in a randomized trial an automated system to detect the need for insulin dose adjustment in between quarterly visits. We will do so by using glucose data to generate personalized management recommendations based on each patient’s physiological and psychosocial data. The research outlined in this proposal aims to lower HbA1c, develop glucose data management and communication systems and support the psychosocial challenges of T1D in a program that is practical, sustainable, and translatable to other Pediatric Diabetes clinics in the US. Specific innovations will be to develop: 1) best practices for providers & T1D patients for glucose and psychosocial outcomes; 2) systems to identify patients with changing insulin needs based on glucose data obtained in between visits; 3) integration of these glucose data into EMR to incorporate into routine clinical practice. In sum, we propose leveraging existing staff and resources to test an innovative approach to improve T1D treatment in our clinic with the goal of obtaining results that will improve healthcare practice and inform healthcare policy for T1D management. We will assess factors that inform sustainability, acceptability, and feasibility. By design, the approach being tested is practical and sustainable with the potential to be broadly disseminated across the US and to improve processes of care and health outcomes for the Pediatric T1D population.


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2024 ( Subtotal = $544,655 )
2024	2024	THE LELAND STANFORD JUNIOR UNIVERSITY	450 JANE STANFORD WAY	STANFORD	CA	94305	SANTA CLARA	USA	Diabetes, Digestive, and Kidney Diseases Extramural Research	000	5	2/5/2024	NON-COMPETING CONTINUATION	$510,615
2024	2024	THE LELAND STANFORD JUNIOR UNIVERSITY	450 JANE STANFORD WAY	STANFORD	CA	94305	SANTA CLARA	USA	Diabetes, Digestive, and Kidney Diseases Extramural Research	001	5	5/17/2024	NON-COMPETING CONTINUATION	$34,040
														Subtotal = $544,655

Issue Date FY: 2023 ( Subtotal = $677,913 )
2023	2023	THE LELAND STANFORD JUNIOR UNIVERSITY	450 JANE STANFORD WAY	STANFORD	CA	94305	SANTA CLARA	USA	Diabetes, Digestive, and Kidney Diseases Extramural Research	000	4	1/30/2023	NON-COMPETING CONTINUATION	$677,913
														Subtotal = $677,913

Issue Date FY: 2022 ( Subtotal = $677,913 )
2022	2022	LELAND STANFORD JUNIOR UNIVERSITY, THE	450 JANE STANFORD WAY	STANFORD	CA	94305	SANTA CLARA	USA	Diabetes, Digestive, and Kidney Diseases Extramural Research	000	3	2/28/2022	NON-COMPETING CONTINUATION	$610,122
2022	2022	LELAND STANFORD JUNIOR UNIVERSITY, THE	450 JANE STANFORD WAY	STANFORD	CA	94305	SANTA CLARA	USA	Diabetes, Digestive, and Kidney Diseases Extramural Research	001	3	4/25/2022	NON-COMPETING CONTINUATION	$67,791
														Subtotal = $677,913

Issue Date FY: 2021 ( Subtotal = $677,913 )
2021	2021	LELAND STANFORD JUNIOR UNIVERSITY, THE	450 JANE STANFORD WAY	STANFORD	CA	94305	SANTA CLARA	USA	Diabetes, Digestive, and Kidney Diseases Extramural Research	000	2	1/30/2021	NON-COMPETING CONTINUATION	$677,913
														Subtotal = $677,913

Issue Date FY: 2020 ( Subtotal = $622,702 )
2020	2020	LELAND STANFORD JUNIOR UNIVERSITY, THE	450 JANE STANFORD WAY	STANFORD	CA	94305	SANTA CLARA	USA	Diabetes, Digestive, and Kidney Diseases Extramural Research	000	1	2/7/2020	NEW	$622,702
														Subtotal = $622,702

Grand Total All Awards = $3,201,096

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Teamwork, Targets, Technology, and Tight Control in Newly Diagnosed Pediatric T1D: 4T Study

Award Number: R18DK122422

ORGANIZATION: NATIONAL INSTITUTE OF DIABETES & DIGESTIVE & KIDNEY DISEASES

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: KDA (KNOWLEDGE/DEVELOPMENT/APPLICATION)

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