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Meet the Expert: Helping Children with Type 1 Diabetes Thrive

Meredith Wilkes, MD is an Endocrinologist at Mount Sinai Kravis Children’s Hospital and an Assistant Professor in the Department of Pediatrics at the Icahn School of Medicine at Mount Sinai in New York City. Dr. Wilkes serves as the medical director of the Pediatric Diabetes Program, the director of a multi-disciplinary pediatric type 1 diabetes clinic, and as a sub-investigator for T1DX-QI.  

Interview with Meredith Wilkes, MD 

In this interview, Wilkes discusses her involvement with the T1D Exchange Quality Improvement Collaborative (T1DX-QI) as a physician-researcher focused on systems and processes to improve the experience of children and families living with T1D. 

The T1DX-QI was established in 2016 — with the support of The Leona M. and Harry B. Helmsley Charitable Trust — to refine best practices and improve the quality of care and outcomes for individuals living with Type 1 diabetes (T1D). Growth has been tremendous, with 54 endocrine clinics from across the U.S. participating in the Collaborative.   

Fueled by top leaders in diabetes care, the T1DX-QI has become an engine of innovation and inspiration. By engaging with the shared, data-driven, and systematic methods of the T1DX-QI, clinics have seen unprecedented success in their approach to diabetes management.   

With members working closely to identify gaps in care, discover and refine best practices, and share research — the process has become knowledge-sharing at its very best. While collated data gives clinics a clear sense of “where they are,” it also demonstrates “where they can be,” by applying shared, evidence-based methods for improving care.  

What led you to endocrinology?  

“My initial exposure to endocrinology was during residency,” said Wilkes. “I loved the diversity of endocrine conditions we saw, and in most cases, how treatable they were.”  

“Throughout my fellowship, I started seeing more children with T1D. As I began to provide specialty education for those newly diagnosed, I discovered that I really enjoyed caring for children living with T1D,” explained Wilkes.  

While Wilkes continues to provide care for children and adolescents with a wide variety of endocrine conditions as a practicing endocrinologist, her primary focus remains on pediatric T1D care.  

What do you enjoy most about your work? 

“I love working with children and couldn’t imagine any alternative,” said Wilkes. “Building long-term relationships with patients and their families brings me great joy.”  

“At Mount Sinai, I’m fortunate to be surrounded by, and collaborate with, wonderful nurses, nurse practitioners, fellow physicians, dietitians, and social workers,” said Wilkes. “I really enjoy working in a supportive team environment that collectively understands the patient and family experience.” 

“Parenting is hard — and being a parent of a child with T1D is even harder. It takes all of the challenges of parenting and multiplies them exponentially,” explained Wilkes. “These individuals shoulder a different level of concern and need ongoing support. Together, we’re proud to provide care to patients and families that extends beyond the walls of the clinic.” 

Mount Sinai and T1DX-QI 

“During the height of COVID, in 2020, is when Mount Sinai initially became involved with the Exchange,” explained Wilkes, who serves as a sub-investigator on the T1DX-QI Transition of Care Committee, along with Robert Rappaport, MD, who serves as the PI for pediatric endocrinology, and Carol Levy, MD who serves as the PI for adult endocrinology. 

“With the pandemic underway, everything had closed in NYC, including our hospital. As you can imagine, it was challenging on many levels, especially seeing cases of new-onset T1D in children who were also diagnosed with COVID,” explained Wilkes.  

It was during this time that Mary Gallagher, MD, from NYU, connected the endocrine team at Mount Sinai with the Exchange as the T1DX-QI began to build the foundation for a COVID registry

“This was an incredible collaboration because we couldn’t have classified the cases on our own,” explained Wilkes. “The T1DX-QI Registry was able to collect an impressive amount of data for all of NYC — and widely across the U.S. — which resulted in collaborations with international COVID registries as well.”  

“After our initial interactions, we stayed on board, officially joining the T1DX-QI, and began to examine depression screening through a QI lens,” said Wilkes. “We’re so grateful to be a part of the T1DX-QI, where everyone is working towards a common goal to improve diabetes care and the quality of life for people living with T1D.”  

Transitions of Care 

“As a member of the T1DX-QI Transition of Care Committee, I can share that we’re just getting started with examining algorithms and methodologies from diabetes centers within T1D Exchange to better understand what optimal transitioning looks like,” explained Wilkes. 

“This period of transition is significant for patients, considering some may have had the same ‘medical home’ for 20 or more years,” reminded Wilkes, with a palpable sense of compassion.  

“It’s also a time in a young adult’s life where they go from being under the care of their parents to being independent — so there are a lot of changes happening at the same time.” 

“As providers, it’s important for us to understand any barriers that may be adding to disjointed care, so we can set patients up for success with a seamless transition process,” said Wilkes, who is dedicated to improving transitions of care and meeting the unique needs of adolescents and young adults as they age out of pediatric care. 

Mount Sinai Diabetes Camp 

“At summer camp, there’s a switch from ‘I have diabetes’ to ‘everyone has diabetes,’ which provides a sense of normalcy and inclusion,” explained Wilkes, who recently volunteered as medical staff at Camp Freedom of the 92nd Street Y. This, after a few years on hold surrounding the pandemic.  

“It was wonderful for us, as providers, to see kids with T1D enjoying themselves in a week-long summer camp environment. When kids are given the opportunity to meet one other and share their common experiences — it’s a joy to witness,” said Wilkes, who went on to explain that the benefits of camp stretch well beyond the physical time spent there. 

What’s next? 

“Our next steps aim to revive two programs at Mount Sinai that came to a halt with the pandemic. They include a teen program and a 6-month peer-support initiative to help improve quality of life measures and A1C values in kids living with T1D,” said Wilkes.  

Additionally, Mount Sinai, in conjunction with NYU, will be co-hosting the T1DX-QI November Sessions. “We’re looking forward to the November Sessions and have been busy coordinating with the Journal of Diabetes reviewing abstracts and preparing for hospital and clinic tours,” said Wilkes. 

Outside of work 

Wilkes lives in New York City with her husband and two children. They enjoy exploring the city together as a family, with the Natural History Museum being one of the kids’ favorite destinations.