Keeping up with type 1 diabetes technology changes in primary care

Greg Forlenza, MD, a pediatric endocrinologist at the Barbara Davis Center for Diabetes at the University of Colorado, discussed the rapid advancements in diabetes technology and how pediatricians can better support care for children with type 1 diabetes.

“In pediatric endocrinology, when we’ve looked at this, we found that over 90% of kids in the United States who have type 1 diabetes are seen by a pediatric endocrinologist,” Forlenza said. He added that this is different from adult diabetes care, which is split among endocrinologists, family medicine, and internal medicine providers.

Forlenza highlighted the fast-paced nature of the field. “In most of medicine, if you’re reading a 5-year-old article, you’re reading something that’s pretty accurate for your field. Whereas in my talks, when I talk about technology, I’ll put something up and be like, this slide is 2 years old. This is super outdated. Most of my stuff is within the last 6 months.” He noted that the speed of advancements makes it challenging for those not immersed in diabetes technology to stay current, but it underscores the importance of advocacy for patient care.

“In the last 5 years, we’ve gone to everyone starts CGM, ideally within the day of diagnosis to the week of diagnosis,” Forlenza explained. He added, “From there, we’re aiming to have people be on automated insulin delivery systems within the first 1–3 months.” He noted that some patients still fall through the cracks, and pediatricians play a critical role in identifying and addressing gaps in care. “If I’m seeing someone that’s not on CGM, this is behind standard of care. Maybe you need to talk to them, see what kind of barriers they’re encountering, make sure that they’re advocating for themselves to be on it.”

Forlenza also discussed a shift in the approach to technology adoption. “We’re moving more towards an opt-out, rather than an opt-in phenomenon, which we believe helps reduce disparities long term.” Pediatricians, he said, can help bridge gaps in care by ensuring patients are referred to the appropriate resources and are on track with current diabetes management standards.