4T Program Improves Diabetes Outcomes Through Advocacy and Technological Solutions

David Maahs, M.D., M.A., Ph.D., from Stanford University, recently co-authored a paper that examined equitable digital health programs for adolescent patients recently diagnosed with type 1 diabetes using the 4T method which focused on the importance of teamwork, targets, technology and tight control.

“Teamwork is the most part of, because it's hard for us all to change, right?” David Maahs, M.D., M.A., Ph.D., from Stanford University. “If the team's not on board with changing, and the good thing is now we can point to our data and the Nature Medicine paper and say it worked.”

Earlier this year, Maahs and his colleagues reported findings from a pragmatic, real-world study of a comprehensive approach of managing type1 diabetes in Nature Medicine. They enrolled 133 young (median age 11) people in the Teamwork, Targets, Technology and Tight Control — 4T, for short — study. At 12 months after enrollment, the participants had an average HbA1c of 6.58% and average glucose monitoring indicator of 7.11%. Close to two-thirds (64%) meet the target HbA1c target of 7%. The study participants had an average “time in range” of 68%, which means their blood sugar levels were in the desired range 68% of the time.

Maahs is currently a pediatric endocrinology professor at Stanford University and the Associate Chair for Academic Affairs in Pediatrics at Stanford University and the Lucile Packard Children’s Hospital.