Introduction and Objective: We aim to describe the barriers clinicians face when prescribing and helping youth with diabetes access medications and technology in the U.S. Methods: A 21-question survey was emailed to Pediatric Endocrine Society practitioners in Spring 2025. Results: Participants (n=120) represented rural, suburban, and urban clinics, with diverse levels of experience and clinical roles (e.g., physician, APP, CDE). The most common challenges when prescribing for youth with T1D and T2D were insurance coverage (86% and 90%), authorizations (84% and 85%, respectively), and pharmacy communication (58% and 46%) (Figure). Challenges with insurance coverage were reported by 74% of T1D clinicians and 89% of T2D clinicians, occurring at least 10% of the time. T1D clinicians faced barriers when prescribing GLP-1 agonists, SGLT-2 inhibitors (75%), insulin pumps, and CGMs (both 55%). For T2D clinicians, prescribing GLP-1 agonists (84%) and CGMs (80%) were hardest, and nearly half had difficulty prescribing pumps. Clinicians used hospital-based pharmacies, nursing/CDE support, specialized personnel for prior authorizations (PA), PA/appeal templates, and prescribing alternative medications. Conclusion: Clinicians face numerous barriers when prescribing diabetes medications and technology for T1D and T2D. Implementing broad policy and institutional changes with additional personnel and financial support are needed. Disclosure P. McAllister: None. A. Flynn: None. J. Lukasik: None. L. Nally: Consultant; Current; Medtronic. Other - independent contractor; Ended; WebMD LLC. Consultant; Ended; Calm, Inc. Advisory Panel; Current; Insulet Corporation. Consultant; Current; Sequel.
MCALLISTER et al. (Fri,) studied this question.