P-502: Early stage T1D education and support (estes): a clinical implementation study
B Frohnert, F Sepulveda, K Hernandez, N Mayer, A Steck, J Stoughton, J Wong, K SimmonsAbstract
Introduction
Adaptive, scalable care models are needed for the emerging early-stage T1D population. Ongoing engagement in monitoring is critical to prevent DKA and identify those who may benefit from immunotherapies.
Objectives
Inclusive engagement of individuals with early-stage T1D and their families into technology/telemedicine-based monitoring and education.
Methods
ESTES includes online tools: a Case Management System (CMS) and bilingual (Eng./Spanish) Learning Management System (LMS). Multiple islet autoantibody-positive individuals were recruited from the Autoimmunity Screening for Kids (ASK) study. Initial visit assessed current T1D stage, baseline diabetes knowledge and psychosocial measures. Baseline blinded CGM was collected with invitation for subsequent unblinded CGM wear supported by telemedicine education. Ongoing data collection includes glycemic status, knowledge acquisition, psychosocial measures and participant-reported experience.
Results
Of 99 families approached to date, 73% agreed to enroll (54% Stage 1, 46% Stage 2 T1D). Characteristics of family/participant groups by enrollment status shown in table. Of participants, 97% are enrolled in the CMS, including autoantibody and glycemic data (Fig). 88% have onboarded to the LMS and 38% have engaged with educational materials. Ongoing activities include telemedicine group sessions; with all participants to date agreeing/strongly agreeing that the information was useful.
Conclusions
Families who enrolled vs declined did not differ significantly by age or sex of participant, demographic group, preferred language, or history of teplizumab infusion. Enrollment in monitoring (CGM/CMS) and education (LMS) has been robust with positive response to date. Future directions include planned expansion to additional study sites, iterative improvement of materials based on family response/engagement, and characterization of clinical status at stage 3 T1D diagnosis.