1105-P: Development and Implementation of a Multidisciplinary Clinic Focused on Youth-Onset Type 2 Diabetes

Abstract

Diabetes self-management education and lifestyle interventions are the cornerstone of type 2 diabetes (T2D) care; however, the higher risk of comorbidities, including depression, among youth with T2D requires a comprehensive care model. Traditionally sub-specialty care relies on a referral model placing the burden on the patient. In response, we developed a pediatric T2D multidisciplinary clinic (MDC) - a single physical location where patients have access to various sub-specialists. The goals of the MDC are to provide access to lifestyle modifications, identify patients who need access to sub-specialty care through screening labs, and improve health care access. We conducted a retrospective chart review of youth seen in the T2D MDC clinic at Cincinnati Children's Hospital from 1/2020 - 12/2021. We evaluated the frequency that youth met with each specialist and completion rates of annual screening labs. The cohort consisted of 227 youth with T2D (mean age 17.6 years, mean BMI 40.9%, 64% female, 50% Black or African American, 65% public insurance). All patients met with a diabetes provider and 81.2% met with a registered dietitian/certified diabetes education specialist. Gastroenterology met with 55.8% of the patients who had elevated liver enzymes, exercise physiology met with 51.6% of patients, social work met with 44.1% of patients, clinical psychology met with 27.3% of patients, and bariatric surgery met with 9.7% of patients. Percent completion of annual labs were: 98.2% for HbA1c, 84.6% for urine microalbumin, 83.7% for lipids, 89.9% for liver function, and 59.5% for retinopathy. The majority of patients received diabetes and nutrition education and annual screening labs. Exercise counseling and sub-specialty care remain below 60% in part because these services are not available at every MDC clinic. Our goals are to increase access to subspecialty care within the MDC's and consider additional care delivery methods to provide comprehensive care to youth with T2D. Disclosure L.R.Schaaf: None. F.Tariq: None. A.S.Shah: None. J.Crail: None. S.Xanthakos: None. J.Sizemore: None. N.A.Crimmins: None. M.Helmrath: None. S.Ley: None. N.Morwessel: None. A.Riegler: None.