Abstract: Towards Risk-based Management of Type 1 Diabetes (T1D): Developing a Population Health Dashboard Based on Performing Diabetes Self-Management Habits
Craig Vandervelden; Brent Lockee; Susana R. Patton; Ryan McDonough; Joyce M Lee; Mark Clements
Children's Mercy Hospitals Kansas City, Missouri, USA
Background/Objectives: Recent research on six pediatric type 1 diabetes (T1D) self-management habits [J. M. Lee et al., JAMA Netw Open. 2021;4(10)], aka “the 6 habits”, which are commonly documented in the electronic health record, offers a new evidence-based measure of engagement with self-management. We created an interactive population health management tool that displays data related to “the 6 habits” for providers and identified a new habit that associates with glycemic control.
Methods: Diabetes device data and electronic medical records for 4293 youth ages 1–27 with T1D from a pediatric diabetes care network in the Midwest USA were imported into “D-Data Dock,” a novel Microsoft Azure-based data lakehouse developed by our team. We designed population health dashboards to display performance of “the 6 habits” plus a 7th habit (“consumes a healthy diet”) by youth, along with their relationship to HbA1c% and time in range (TIR). Providers can explore habit performance in the population by various demographics and drill down to the individual patient level.
Results: Habit performance varied significantly by individual and by habit. Performing a larger total number of habits was associated with stepwise improvements in both HbA1c% and TIR. Performance of a 7th (healthy eating) habit was associated with a further reduction in HbA1c%.
Conclusions: We have validated “the 6 habits” as a composite biomarker of engagement in T1D self-management and identified a 7th habit that associates with glycemic control. Tracking these habits may assist providers with selecting interventions to improve glycemic control among youth.
Keywords: adherence, hemoglobin A1c, type 1 diabetes