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Stanford to pilot support program for primary care providers to reach underserved patients with Type 1 diabetes

Adults and children living with Type 1 diabetes require close monitoring and regular check-ins with a diabetes specialist or endocrinologist to maintain effective control of their condition. However, not all have access to these specialists, due to a number of factors including racial, socioeconomic and geographic disparities that affect health outcomes among these patients. Now, clinical researchers at Lucile Packard Children’s Hospital Stanford are helping to study ways to improve care access for underserved adults and children living with the disease. 

Patients with Type 1 diabetes, particularly lower-income urban and rural residents, may lack access to care that would optimize their diabetes management. In those cases, patients may be getting insulin from their family doctor but lacking access to emerging technologies and therapies and other diabetes management techniques. The American Diabetes Association recommends visits to a specialist once every three months.

The 18-month, $1.6 million pilot grant was awarded by The Leona M. & Harry B. Helmsley Charitable Trust to the University of Florida, as the coordinating center for the study, led by Michael J. Haller, MD, Professor and Chief of Pediatric Endocrinology in the UF College of Medicine, and Ashby Walker, PhD, the Director of Health Equity Initiatives at the UF Diabetes Institute. Stanford will serve as the West Coast hub for the pilot, led by David Maahs, MD, PhD, chief of pediatric endocrinology at Lucile Packard Children’s Hospital Stanford. The researchers will begin outreach in early 2018 to primary health care providers in California and Florida, whose patients with diabetes do not have access to care by an endocrinologist or diabetes specialist. The primary providers will receive virtual training and tele-education from the diabetes “hubs” at Stanford and Florida. The physicians also will get real-time help with challenging medical decision-making issues from diabetes professionals as well as a diabetes care liaison assigned to their clinic and opportunities to enroll their patients in research projects and initiatives at the hubs.

Nicolas Cuttriss, MD, MPH, assistant clinical professor of endocrinology and diabetes at Stanford, joins Maahs after serving as the pediatric endocrinologist for the Extension for Community Health Care Outcomes model, also known as Project ECHO® at the University of New Mexico. The ECHO model is designed to provide best practice care for underserved people by giving primary care providers additional knowledge and support to manage patients with complex conditions. It has been adapted for a range of diseases, including endocrinology, HIV, hepatitis C and chronic pain, and this will be the first time it is applied exclusively to Type 1 diabetes. The ECHO Institute at the University of New Mexico will also provide additional technical support in the grant

Primary care providers who are interested in participating in the Type 1 diabetes Project ECHO program can contact the researchers at

The Stanford team is enrolling providers who care for adult and/or pediatric patients with Type 1 diabetes.

Learn more at


Contact Information

Marissa Town
Katarina Yabut
Phone: (650) 497-4793