The patients of the Endocrinology medical service use numerous remote care monitoring devices (e.g., insulin pumps and glucometers). The goal of this project is to design a comprehensive system for patients to learn to use these devices; to deliver the data to healthcare providers; and to put a system in place to analyze the data and track the outcomes of the work.
Intensive glucose control in patients with type 1 diabetes (T1D) is essential to prevent the development of vascular complications. However, in the United States only ~25% of children and adolescents with T1D meet long-term glucose control goals. Despite the high incidence and significant morbidity and mortality associated with T1D, few quantitative tools to personalize care models are available and deteriorating glucose control is often detected only retrospectively. A typical patient may check their blood glucose 4-10 times/day and receive feedback from their care team once every 3 months based on a single lab value (HbA1c) that represents glucose control over the past 3 months. Continuous glucose monitors (CGMs), which record blood glucose levels once every 5 minutes, offer an opportunity to use high-frequency data to identify and predict deteriorating glucose control.
In close partnership with LPCH and the Stanford School of Medicine Division of Pediatric Endocrinology, we are developing tools that use CGM data to assist clinical teams in workflows to detect, predict, and ameliorate deteriorating glucose control. These automated decision-support tools will support the care team as they work with patients to: set personalized blood glucose goals, monitor patient progress towards these goals, identify deteriorating control, and identify a therapeutic response to regain tighter control.
Learn more about CGMs here.
