2109-P: BOARD-T1D: A Multidisciplinary Care Management Program for Youth with Ongoing Challenges in Type 1 Diabetes Management

Introduction and Objective: Despite advances in diabetes technology and clinical care, youth with type 1 diabetes (T1D) continue to have HbA1c levels above recommended targets. We implemented and evaluated BOARD-T1D (Building Outreach Assistance Resources and Direction in T1D), an individualized, multidisciplinary care management program designed to support diabetes management in youth with ongoing glycemic challenges. Methods: Youth were referred at provider discretion if HbA1c was 8% and T1D duration 1 year. Program components included proactive outreach, patient- and family-centered care coordination, diabetes education, community resource navigation, and monthly multidisciplinary case reviews involving a pediatric endocrinologist, registered nurse care manager, diabetes educator, dietitian, social worker, and psychologist. A standardized EHR tool documented recommendations and longitudinal progress. Primary outcome was change in HbA1c; secondary outcomes included emergency department (ED) utilization and hospital admissions for acute diabetes complications Results: Fifty-eight youth (mean age 13.6 years) were enrolled, with mean participation of 14.5 ± 5.9 months and baseline HbA1c of 11.4% ± 2.0. HbA1c improved by 1.9% ± 2.3 (p0.001), with 74% achieving reductions 0.5%. Hospital admissions decreased 38%, while ED utilization was unchanged. Greater improvements occurred in youth with higher baseline HbA1c and no prior CGM use, with smaller improvements in non-English-speaking families and youth with a history of behavioral health conditions. Regression analyses suggested technology adoption alone did not explain most of the improvement. Conclusion: BOARD-T1D was associated with improved glycemic outcomes in most enrolled youth, underscoring the impact of longitudinal, multidisciplinary care addressing social and contextual health factors beyond conventional standards of care. Disclosure A.L. Ghaben: None. K. McNamara: None. C.J. Guzman: None. M. Scharf: None. A. Martens: None. E. Basore: None. J. Helder: None. B. Britton: None. B. Leggett: None. M. Bialostozky: None. C. Demeterco-Berggren: Advisory Panel; Ended; Sanofi. Board Member; Current; Glooko, Inc. Research Support; Ended; Medtronic.