Janaki Vakharia, MD

Pronouns

She/Her/Hers

Rank

Clinical Fellow

Institution

MGH

BWH-MGH Title

Clinical and Research Endocrinology Fellow

Department

Medicine and Pediatrics

Authors

*Janaki Dave Vakharia, MD, *Deborah J. Wexler, MD, MSc

Feasibility and characteristics of an innovative care model for young adults with diabetes mellitus at Massachusetts General Hospital Diabetes Center

WMSS 2022

I aim to become a clinical leader and innovator in healthcare transition for young adults with chronic endocrine conditions. I admire the women physicians before me who trail-blazed the path for women like me and feel is it important to continue forging this path to enhance representation and recognition. The WIMSS fits this mission and will provide me the opportunity to learn from the accomplishments of other women physicians/scientists and allows me to be part of a powerful community across the MGH/BWH/MGB system of women physicians/scientist who I may partner with to excel, innovate, and lead as a united force.

Background

Young adults with diabetes mellitus have a high prevalence of mental health (MH) disorders and uncontrolled diabetes. Behavioral health professionals (BHP) are not a standard part of adult diabetes care but could help address barriers to effective self-management.

Methods

We piloted a diabetes collaborative care model for young adults with diabetes (DCCYA) that incorporates a BHP alongside a diabetes care provider during joint office visits. Eligible patients included new patients to the MGH Diabetes Center, 18-30 years old, with type 1 (T1D) or type 2 diabetes. We determined DCCYA feasibility, defined by clinic volume and retention rate, and described DCCYA patient characteristics, from 9/1/2021-6/1/2022.

Results

There were 23 DCCYA patients (29% of eligible patients) and 55 (71%) usual care patients. Fifteen DCCYA patients were due for follow-up and 14 (93%) were retained. DCCYA patients were mean age 24+2 years, 26% female, and 78% non-Hispanic white. Most (96%) had T1D with diabetes duration of 11+6 years. At presentation, 48% had a clinical history of MH disorders. Baseline HbA1c of DCCYA patients was 8.6+2.4%; this improved to 7.6%+1.7 (NS).

Conclusion

DCCYA is feasible. Future reports will compare characteristics and diabetes and MH care parameters of DCCYA patients with usual care patients.