O-30: Closing the gap in diabetes technology and glycemia: the blossom clinic experience
J Grundman, M Habib, M Tran, L Clary, L DeAnna, R Velasquez, A PerkinsAbstract
Introduction
Youth with T1D often face clinical and social barriers that limit adoption of diabetes technologies. The Blossom Clinic is a multidisciplinary program at a tertiary center in Washington DC, USA designed to address these barriers through coordinated support. Eligible participants have T1D ≥1 year with ≥2 HbA1c values >10% or ≥2 DKA admissions in the prior year. The program includes 4 visits with a provider, psychologist, social worker, CDCES, pharmacist, and health coach, along with supports such as transportation stipends, groceries, and CGM samples.
Objectives
To evaluate whether Blossom Clinic participation improved glycemia and increased adoption of diabetes technology among youth with historically low uptake.
Methods
We performed a retrospective analysis of participants with >2 visits. Paired analyses assessed changes in HbA1c. McNemar tests evaluated changes in CGM and AID use, and X2 test assessed technology adoption by race/ethnicity and insurance status. Spearman correlation assessed associations between multidisciplinary involvement and HbA1c change.
Results
Forty-one youth met inclusion criteria (Table 1). Mean HbA1c improved from 11.8% to 10.6% (p<0.01). CGM use increased from 29.3% to 70.7% (p=0.04), and AID use from 39.0% to 61.0% (p<0.01). Technology adoption did not differ by race/ethnicity (CGM adoption p=0.37, AID adoption p=0.21), though AID use was higher among privately insured youth (p=0.03). Greater multidisciplinary involvement showed a trend toward greater improvement in HbA1c (ρ=-0.27, p=0.09).
Conclusions
Participation in a multidisciplinary clinic addressing medical, behavioral, and social barriers was associated with improved glycemia and diabetes technology adoption in a historically underserved population. Persistent insurance-related differences in AID uptake highlight ongoing structural barriers to diabetes technology access.