About

Dr. Ananta Addala is an Assistant Professor of Pediatrics (Endocrinology) at Stanford University. She is a pediatric endocrinologist and physician scientist dedicated to addressing access issues in pediatric type 1 diabetes management and outcomes. Her work focuses on building an evidence-based approach to tackling disparities in T1D care by systematically evaluating barriers faced by youth, families, providers, and healthcare systems, particularly in relation to diabetes technology utilization. Her research has demonstrated that socioeconomic disparities in pediatric T1D are worsening in the US, that provider bias against public insurance is common, and that interruptions to diabetes technology mediated by public insurance negatively impact glycemic outcomes. She has led efforts to recruit and retain individuals at risk for or living with diabetes through engagement initiatives, her leadership at Stanford Pediatrics, and her role as co-chair of TrialNet's Recruitment Engagement Committee.

Research topics

• Medicine
• Internal medicine
• Endocrinology
• Pediatrics
• Demography
• Gerontology
• Environmental health
• Family medicine
• Virology

Selected publications

• A Quantitative Framework for Evaluating the Performance of Algorithm-Directed Whole-Population Remote Patient Monitoring: Tutorial for Type 1 Diabetes Care

  JMIR Diabetes · 2026-02-02

  articleOpen access

  Unlabelled: Clinics continue to adopt care models shaped by the algorithmic analysis of continuous glucose monitoring (CGM) data, such as remote patient monitoring for type 1 diabetes. No clinic-facing quantitative framework currently exists to track the impact of such algorithm-directed care on patient outcomes and clinical workload. We used CGM data from the Teamwork, Targets, Technology, and Tight Control (4T) Study (Pilot n=135 and Study 1 n=133), in which algorithms enable precision, whole-population care by directing clinician attention to patients with deteriorating glucose management. Youth meeting criteria for clinical review are then contacted by Certified Diabetes Care and Education Specialists. Through iterative data analysis and meetings with a variety of stakeholders, we identified metrics for reviewing and revising clinical workloads, glucose management, and timeliness of care. For each metric, we developed an interactive dashboard to provide clinical and administrative leaders with an overview of the program. The metrics to track clinical workload were the total number of youths (1) in the program, (2) in each study, and (3) cared for by each clinician. The metrics to track glucose management were the number of youths meeting each criterion for review, including (4) total, (5) for each clinician, and (6) for each study. The metric to track timeliness of care was (7) the number of days since meeting criteria for clinical review. When presented at regular program leadership meetings, the metrics facilitated data-driven decision-making about clinical and operational components of the program. In this paper, we describe the process of developing and operationalizing this reproducible, clinician-facing key performance indicator tool to monitor an algorithm-enabled remote patient monitoring program. As the role of algorithms grows in directing clinical effort and prioritizing patients for care, this framework may help clinics track clinical workload, patient outcomes, and the timeliness of care.

  PublisherDOI

• Cost-effectiveness of continuous glucose monitoring with remote patient monitoring in pediatric patients with newly diagnosed type 1 diabetes in the United States

  2026-03-25

  article

  <p dir="ltr"><b>Objective: </b>The use of continuous glucose monitoring (CGM) with remote patient monitoring (RPM) continues to grow. We evaluated the cost-effectiveness of CGM with RPM compared to self-monitoring of blood glucose (SMBG) and CGM alone.</p><p dir="ltr"><b>Research design and methods: </b>We simulated type 1 diabetes progression with a Markov model in 5-year-old patients over a 20-year, 50-year, and age 100 horizon. We tracked diabetic ketoacidosis (DKA), severe hypoglycemia (SH), and seven chronic complications: retinopathy, neuropathy, nephropathy, cardiovascular disease, end-stage renal disease, lower-extremity amputation, and blindness. We compared three interventions: SMBG, CGM, and CGM with RPM. Efficacy estimates were derived from meta-analyses of pediatric CGM studies and the results of the Teamwork, Targets, Technology, and Tight Glycemia Study (4T Study 1). We evaluated quality-adjusted life years (QALYs) and healthcare costs (2022 U.S. dollars) discounted at 3% annually. We performed extensive sensitivity analyses.</p><p dir="ltr"><b>Results: </b>Compared to SMBG, CGM increased QALYs by 0.09 and costs by $8,900 over 20 years; CGM with RPM increased QALYs by 0.37 and costs by $10,300 CGM with RPM yielded more QALYs at a lower incremental cost-effectiveness ratio compared to CGM ($27,400/QALY vs $103,700/QALY, respectively). Results were robust across sensitivity analyses and time horizons. CGM with RPM remained cost-effective when achieving at least 30% of 4T’s clinical efficacy.</p><p dir="ltr"><b>Conclusions: </b>CGM with RPM delivers superior health outcomes compared to SMBG and CGM and is likely cost-effective for patients with newly diagnosed type 1 diabetes. Despite higher intervention costs, CGM with RPM can reduce complications costs and generate net healthcare savings.</p>

  PublisherDOI

• Building the evidence to address disparities in type 1 diabetes (BEAD-T1D): methods and design of a study examining barriers and promoters to diabetes device use in families with public insurance

  Frontiers in Endocrinology · 2026-04-27

  articleOpen accessSenior author

  Continuous glucose monitoring (CGM) and automated insulin delivery (AID) systems have led to improved outcomes in type 1 diabetes (T1D). Diabetes technology use in minoritized populations is 50% lower than more privileged groups. Tailored, multi-factorial interventions are needed to address disparities and improve technology uptake in minoritized youth with T1D. The Building the Evidence to Address Disparities in Type 1 Diabetes (BEAD-T1D) Study assesses drivers of disparities in CGM and AID use in youth with T1D and public insurance to develop an intervention to increase uptake of diabetes technology. This manuscript describes the rationale, design, and protocols of the study. BEAD-T1D is a prospective, mixed-methods study grounded in the social-ecological model informed by sequential triangulation. Study Aim 1 constructs an evidence base of barriers and promoters to CGM and AID use in youth with T1D and public insurance to formulate and test a pilot intervention to increase device uptake in minoritized populations. Study Aim 2 constructs an evidence base of barriers and promoters to recommending devices to youth with T1D and public insurance to formulate and test a pilot intervention for healthcare providers to increase recommendations of devices. The primary outcome is diabetes technology acceptance analyzed via descriptive statistics and univariate analyses to inform the systematic building of a multivariable model. BEAD-T1D lays the groundwork for future efforts to reduce disparities in the uptake and continued use of diabetes technology in marginalized populations. Interventions effective in increasing the uptake and continued use of diabetes technology in youth with T1D and public insurance are necessary to mitigate disparities.

  PublisherOA PDFDOI

• The <i>Real</i> “Real World”: Overcoming Practical Barriers and Disparities in Diabetes Technology

  Diabetes Technology & Therapeutics · 2026-03-01

  article1st authorCorresponding
  PublisherDOI

• Cost-Effectiveness of Continuous Glucose Monitoring With Remote Patient Monitoring in Pediatric Patients With Newly Diagnosed Type 1 Diabetes in the U.S.

  Diabetes Care · 2026-03-25

  articleOpen access

  OBJECTIVE: The use of continuous glucose monitoring (CGM) with remote patient monitoring (RPM) continues to grow. We evaluated the cost-effectiveness of CGM with RPM compared with self-monitoring of blood glucose (SMBG) and CGM alone. RESEARCH DESIGN AND METHODS: We simulated type 1 diabetes progression with a Markov model in 5-year-old patients over a 20-year, 50-year, and lifetime horizon. We tracked diabetic ketoacidosis (DKA), severe hypoglycemia (SH), and seven chronic complications: retinopathy, neuropathy, nephropathy, cardiovascular disease, end-stage renal disease, lower-extremity amputation, and blindness. We compared three interventions: SMBG, CGM, and CGM with RPM. Efficacy estimates were derived from meta-analyses of pediatric CGM studies and the results of the Teamwork, Targets, Technology, and Tight Glycemia Study (4T Study 1). We evaluated quality-adjusted life years (QALYs) and health care costs (2022 U.S. dollars) discounted at 3% annually. We performed extensive sensitivity analyses. RESULTS: Compared with SMBG, CGM increased QALYs by 0.09 and costs by $8,900 over 20 years; CGM with RPM increased QALYs by 0.37, and costs by $10,300. CGM with RPM yielded more QALYs at a lower incremental cost-effectiveness ratio compared with CGM ($27,400/QALY vs. $103,700/QALY, respectively). Results were robust across sensitivity analyses and time horizons. CGM with RPM remained cost-effective when achieving at least 30% of 4T's clinical efficacy. CONCLUSIONS: CGM with RPM delivers superior health outcomes compared with SMBG and CGM and is likely cost-effective for patients with newly diagnosed type 1 diabetes. Despite higher intervention costs, CGM with RPM can reduce complications costs and generate net health care savings.

  PublisherOA PDFDOI

• Cost-effectiveness of continuous glucose monitoring with remote patient monitoring in pediatric patients with newly diagnosed type 1 diabetes in the United States

  2026-03-25

  article

  &lt;p dir="ltr"&gt;&lt;b&gt;Objective: &lt;/b&gt;The use of continuous glucose monitoring (CGM) with remote patient monitoring (RPM) continues to grow. We evaluated the cost-effectiveness of CGM with RPM compared to self-monitoring of blood glucose (SMBG) and CGM alone.&lt;/p&gt;&lt;p dir="ltr"&gt;&lt;b&gt;Research design and methods: &lt;/b&gt;We simulated type 1 diabetes progression with a Markov model in 5-year-old patients over a 20-year, 50-year, and age 100 horizon. We tracked diabetic ketoacidosis (DKA), severe hypoglycemia (SH), and seven chronic complications: retinopathy, neuropathy, nephropathy, cardiovascular disease, end-stage renal disease, lower-extremity amputation, and blindness. We compared three interventions: SMBG, CGM, and CGM with RPM. Efficacy estimates were derived from meta-analyses of pediatric CGM studies and the results of the Teamwork, Targets, Technology, and Tight Glycemia Study (4T Study 1). We evaluated quality-adjusted life years (QALYs) and healthcare costs (2022 U.S. dollars) discounted at 3% annually. We performed extensive sensitivity analyses.&lt;/p&gt;&lt;p dir="ltr"&gt;&lt;b&gt;Results: &lt;/b&gt;Compared to SMBG, CGM increased QALYs by 0.09 and costs by $8,900 over 20 years; CGM with RPM increased QALYs by 0.37 and costs by $10,300 CGM with RPM yielded more QALYs at a lower incremental cost-effectiveness ratio compared to CGM ($27,400/QALY vs $103,700/QALY, respectively). Results were robust across sensitivity analyses and time horizons. CGM with RPM remained cost-effective when achieving at least 30% of 4T’s clinical efficacy.&lt;/p&gt;&lt;p dir="ltr"&gt;&lt;b&gt;Conclusions: &lt;/b&gt;CGM with RPM delivers superior health outcomes compared to SMBG and CGM and is likely cost-effective for patients with newly diagnosed type 1 diabetes. Despite higher intervention costs, CGM with RPM can reduce complications costs and generate net healthcare savings.&lt;/p&gt;

  PublisherDOI

• Diabetes Technology in the “Real World”: Employing New Paradigms to Improve Outcomes and Address Disparities

  Diabetes Technology & Therapeutics · 2025-03-01

  articleOpen accessSenior author
  PublisherOA PDFDOI

• Disparities in access to and use of diabetes technologies and therapeutics: a narrative review

  Diabetologia · 2025-07-22 · 11 citations

  review1st authorCorresponding
  PublisherDOI

• Physical Activity Is Associated With Improved Glycemic Outcomes in Newly Diagnosed Youth With Type 1 Diabetes: 4T Exercise Program

  Diabetes Care · 2025-07-01 · 5 citations

  articleOpen access

  OBJECTIVE: The Teamwork, Targets, Technology, and Tight Range (4T) Exercise Program evaluated physical activity patterns across the first year of type 1 diabetes diagnosis and whether physical activity was associated with changes in glucose outcomes in the 24 h following physical activity. RESEARCH DESIGN AND METHODS: The 4T Exercise Program started newly diagnosed youth with type 1 diabetes on a continuous glucose monitoring (CGM) system and physical activity tracker around 1 month postdiagnosis. A subset of youth opted to participate in up to four quarterly structured exercise education sessions to increase their knowledge around safe physical activity. RESULTS: Ninety-eight youth with type 1 diabetes (median [interquartile range (IQR)] age of 13 [12-15] years, 45% female, 44% non-Hispanic White) completed the study. Compared with sedentary days, days with ≥10 min of vigorous-intensity physical activity were associated with an increase in time in range (TIR) of 2.3% (1.4-3.2%; P < 0.001), a decrease in time above range (TAR) of 3.1% (2.2-4.0%; P < 0.001), and an increase in time below range (TBR) of 0.8% (0.6-0.9%; P < 0.001) in the 24 h following physical activity. From 1-3 months to 10-12 months postdiagnosis, the median (IQR) step count increased by 1,134 (445-1,519) steps per day (P < 0.001), while daily moderate-to-vigorous physical activity increased by 11 (2-23) min per day (P < 0.001). CONCLUSIONS: In the 24 h following physical activity as compared with sedentary days, TIR improved, TAR was lower, and TBR remained within clinical target recommendations. For youth with new-onset type 1 diabetes, each structured exercise education session was associated with a further 0.79% increase in TIR.

  PublisherOA PDFDOI

• 1139-P: Assessing Clinic Readiness for Implementation of Equitable and Sustainable New-Onset Care in the T1DX-QI

  Diabetes · 2025-06-13

  article

  Introduction and Objective: The 4T Program emphasizes early and equitable initiation of diabetes technology with an interdisciplinary team approach to achieve optimal glycemic outcomes. The T1D Exchange Quality Improvement Collaborative (T1DX-QI) focuses on healthcare equity and improving care and outcomes. A collaboration between the 4T Program and the T1DX-QI is proposed to equitably improve new-onset care and address existing gaps in care for youth with T1D in the US. Methods: A survey of pediatric new-onset programs, resources, and potential challenges was sent to 16 T1DX-QI centers that attended a 4T program information webinar to assess implementation readiness. These findings will inform redesigning implementation and dissemination of new-onset care at T1DX-QI centers. Results: Fifteen centers completed the survey via REDCap describing their center’s characteristics (Table). Potential key challenges identified in implementing the 4T program included provider time for program delivery (93%) and informatics support concerns (47%). Other challenges included provider buy-in (20%) and the ability to provide device and technology support to families (20%). Conclusion: These data are being utilized in a 4T-T1DX-QI workshop to collaboratively discuss strategies with the same 15 centers to design equitable and sustainable implementation of improved new-onset care at T1DX-QI centers. Disclosure F.K. Bishop: None. A. Addala: None. G.T. Alonso: Advisory Panel; MannKind Corporation. L.C. Chao: None. A. Choudhary: None. M.A. Clements: Consultant; Glooko, Inc. Research Support; Dexcom, Inc., Abbott. D. DeSalvo: Consultant; Dexcom, Inc. Advisory Panel; Insulet Corporation. M. Desai: None. R. Johari: None. D.M. Maahs: Advisory Panel; Abbott, Medtronic. Research Support; Dexcom, Inc. Consultant; Sanofi. A. Mucci: None. P. Prahalad: Consultant; Sanofi. N. Rioles: None. S. Thapa: None. D.P. Zaharieva: Research Support; Hemsley Charitable Trust. Speaker's Bureau; Dexcom, Inc. Research Support; Insulet Corporation, International Society for Pediatric and Adolescent Diabetes. O. Ebekozien: Research Support; Abbott. Advisory Panel; Sanofi. Research Support; Sanofi, Lilly Diabetes, Medtronic. Funding The Leona M. and Harry B. Helmsley Charitable Trust

  PublisherDOI

Recent grants

• Reducing Disparities in Pediatric Diabetes: Building the Evidence Base to Inform Effective Diabetes Technology Interventions in Underrepresented Minorities

  NIH · $970k · 2022–2026

Frequent coauthors

• David M. Maahs

  133 shared

• Dessi P. Zaharieva

  Stanford University

  88 shared

• Priya Prahalad

  Stanford University

  80 shared

• David Scheinker

  67 shared

• Klemen Dovč

  University of Ljubljana

  56 shared

• Tadej Battelino

  54 shared

• Korey K. Hood

  Stanford University

  53 shared

• Ramesh Johari

  53 shared

Labs

• Vice Provost for Student AffairsPI