Bio

Bio


I am a physician scientist addressing disparities in type 1 diabetes (T1D) management and outcomes. My research interests are at the intersection of T1D and inequities evaluating system-level and individual-level contributors to T1D disparities. My longstanding research and clinical interests are to promote equitable care for youth with T1D informed by the biological, social, psychological, and systemic determinants of health.

Clinical Focus


  • Diabetes and Metabolism
  • Endocrinology

Academic Appointments


Professional Education


  • Fellowship: Stanford University Pediatric Endocrinology Fellowship (2020) CA
  • Residency: LACplusUSC Pediatric Residency (2017) CA
  • Board Certification: American Board of Pediatrics, Pediatrics (2016)
  • Medical Education: University of New England College of Osteopathic Medicine (2013) ME

Publications

All Publications


  • Uninterrupted Continuous Glucose Monitoring Access is Associated with a Decrease in HbA1c in Youth with Type 1 Diabetes and Public Insurance. Pediatric diabetes Addala, A., Maahs, D. M., Scheinker, D., Chertow, S., Leverenz, B., Prahalad, P. 2020

    Abstract

    OBJECTIVE: Continuous glucose monitor (CGM) use is associated with improved glucose control. We describe the effect of continued and interrupted CGM use on hemoglobin A1c (HbA1c) in youth with public insurance.METHODS: We reviewed 956 visits from 264 youth with type 1 diabetes (T1D) and public insurance. Demographic data, HbA1c and two-week CGM data were collected. Youth were classified as never user, consistent user, insurance discontinuer, and self-discontinuer. Visits were categorized as never-user visit, visit before CGM start, visit after CGM start, visit with continued CGM use, visit with initial loss of CGM, visit with continued loss of CGM, and visit where CGM is regained after loss. Multivariate regression adjusting for age, sex, race, diabetes duration, initial HbA1c, and BMI were used to calculate adjusted mean and delta HbA1c.RESULTS: Adjusted mean HbA1c was lowest for the consistent user group (HbA1c 8.6%;[95%CI 7.9,9.3]). Delta HbA1c (calculated from visit before CGM start) was lower for visit after CGM start (-0.39%;[95%CI -0.78,-0.02]) and visit with continued CGM use (-0.29%;[95%CI -0.61,0.02]) whereas it was higher for visit with initial loss of CGM (0.40%;[95%CI -0.06,0.86]), visit with continued loss of CGM (0.46%;[95%CI 0.06,0.85]), and visit where CGM is regained after loss (0.57%;[95%CI 0.06,1.10]).CONCLUSIONS: Youth with public insurance using CGM have improved HbA1c, but only when CGM use is uninterrupted. Interruptions in use, primarily due to gaps in insurance coverage of CGM, were associated with increased HbA1c. These data support both initial and ongoing coverage of CGM for youth with T1D and public insurance. This article is protected by copyright. All rights reserved.

    View details for DOI 10.1111/pedi.13082

    View details for PubMedID 32681582

  • ISPAD Annual Conference 2019 Highlights. Pediatric diabetes Addala, A., March, C., Marks, B., Tommerdahl, K., Shapiro, J., Oyenusi, E., Yauch, L. M., Goethals, E. R., Ahmad, P. O., Adhami, S., Ng, M., Ehtisham, S., Agwu, J. C. 2020; 21 (2): 152?57

    View details for DOI 10.1111/pedi.12986

    View details for PubMedID 32022991

  • Unintended Consequences of COVID-19: Remember General Pediatrics. The Journal of pediatrics Cherubini, V., Gohil, A., Addala, A., Zanfardino, A., Iafusco, D., Hannon, T., Maahs, D. M. 2020

    View details for DOI 10.1016/j.jpeds.2020.05.004

    View details for PubMedID 32437758

    View details for PubMedCentralID PMC7207102

  • Improving Clinical Outcomes in Newly Diagnosed Pediatric Type 1 Diabetes: Teamwork, Targets, Technology, and Tight Control-The 4T Study. Frontiers in endocrinology Prahalad, P., Zaharieva, D. P., Addala, A., New, C., Scheinker, D., Desai, M., Hood, K. K., Maahs, D. M. 2020; 11: 360

    Abstract

    Many youth with type 1 diabetes (T1D) do not achieve hemoglobin A1c (HbA1c) targets. The mean HbA1c of youth in the USA is higher than much of the developed world. Mean HbA1c in other nations has been successfully modified following benchmarking and quality improvement methods. In this review, we describe the novel 4T approach-teamwork, targets, technology, and tight control-to diabetes management in youth with new-onset T1D. In this program, the diabetes care team (physicians, nurse practitioners, certified diabetes educators, dieticians, social workers, psychologists, and exercise physiologists) work closely to deliver diabetes education from diagnosis. Part of the education curriculum involves early integration of technology, specifically continuous glucose monitoring (CGM), and developing a curriculum around using the CGM to maintain tight control and optimize quality of life.

    View details for DOI 10.3389/fendo.2020.00360

    View details for PubMedID 32733375

    View details for PubMedCentralID PMC7363838

  • Gluconeogenesis and Insulin in the Ketotic Variety of Childhood Hypoglycemia and in Control Children JOURNAL OF PEDIATRICS Addala, A., Maahs, D. M. 2019; 207: 122
  • Depression in Context: Important Considerations for Youth with Type 1 vs Type 2 Diabetes. Pediatric diabetes Wong, J. J., Addala, A., Abujaradeh, H., Adams, R. N., Barley, R. C., Hanes, S. J., Iturralde, E., Lanning, M. S., Naranjo, D., Tanenbaum, M. L., Hood, K. K. 2019

    Abstract

    Youth with diabetes are at increased risk for depression. However, severity and correlates of depressive symptoms may differ by diabetes type.Associations of depressive symptoms with global health, diabetes duration, and gender were compared between youth with type 1 and type 2 diabetes.A sample of 149 youth ages 12-21 diagnosed with either type 1 (n=122) or type 2 (n=27) diabetes were screened during routine clinic appointments. Regression models were constructed to examine differences by diabetes type.Adolescents with type 2 diabetes had significantly higher depressive symptom scores (4.89 vs 2.99, P=0.025) than those with type 1 diabetes. A significant interaction between global health and diabetes type on depressive symptoms revealed inverse associations between global health and depressive symptoms that was stronger among youth with type 2 diabetes (?=-0.98, P?

    View details for DOI 10.1111/pedi.12939

    View details for PubMedID 31644828

  • CGM Initiation Soon After Type 1 Diabetes Diagnosis Results in Sustained CGM Use and Wear Time. Diabetes care Prahalad, P., Addala, A., Scheinker, D., Hood, K. K., Maahs, D. M. 2019

    View details for DOI 10.2337/dc19-1205

    View details for PubMedID 31558548

  • The Interplay of Type 1 Diabetes and Weight Management: A Qualitative Study Exploring Thematic Progression from Adolescence to Young Adulthood. Pediatric diabetes Addala, A., Igudesman, D., Kahkoska, A. R., Muntis, F. R., Souris, K. J., Whitaker, K. J., Pratley, R. E., Mayer-Davis, E. 2019

    Abstract

    The impact of weight management in persons with type 1 diabetes (T1D) from childhood into adulthood has not been well-described. The purpose of the study was to explore qualitative themes presented by young adults with T1D with respect to the dual management of weight and T1D.We analyzed focus group data from 17 young adults with T1D (65% female, age 21.7??2.1?years, HbA1c 8.1%??1.5) via inductive qualitative analysis methods. Major themes were compared to themes presented by youth with T1D ages 13-16?years in previously published study in order to categorize thematic progression from early adolescence through adulthood.Themes from young adults with T1D, when compared to those from youth, were categorized as: (1) persistent and unchanged themes, (2) evolving themes, and (3) newly-reported themes. Hypoglycemia and a sense of futility around exercise was an unchanged theme. Importance of insulin usage and a healthy relationship with T1D evolved to gather greater conviction. Newly reported themes are unique to integration of adulthood into T1D, such as family planning and managing T1D with work obligations. Young adults also reported negative experiences with providers in their younger years and desire for more supportive provider relationships.Issues identified by youth regarding the dual management of T1D and weight rarely resolve, but rather, persist or evolve to integrate other aspects of young adulthood. Individualized and age-appropriate clinical support and practice guidelines are warranted to facilitate the dual management of weight and T1D in persons with T1D. This article is protected by copyright. All rights reserved.

    View details for DOI 10.1111/pedi.12903

    View details for PubMedID 31392807

  • 50 Years Ago in The Journal of Pediatrics: Gluconeogenesis and Insulin in the Ketotic Variety of Childhood Hypoglycemia and in Control Children. The Journal of pediatrics Addala, A., Maahs, D. M. 2019; 207: 122

    View details for PubMedID 30922489

  • Sustained Continuous Glucose Monitor Use in Low-Income Youth with Type 1 Diabetes Following Insurance Coverage Supports Expansion of Continuous Glucose Monitor Coverage for All DIABETES TECHNOLOGY & THERAPEUTICS Prahalad, P., Addala, A., Buckingham, B., Wilson, D. M., Maahs, D. M. 2018; 20 (9): 632?34
  • Can Real World Evidence on Body Mass Index Trajectories Inform Clinical Practice? The Journal of pediatrics Addala, A., Maahs, D. M. 2018

    View details for PubMedID 30025670

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