About

Tricia Santos Cavaiola is a Clinical Professor in the Department of Medicine at UC San Diego. Her research focuses on the utilization of continuous glucose monitoring in primary care practice, management of patients with Type 2 Diabetes, and inhaled insulin therapies. She has contributed to publications in these areas, including studies on blood glucose self-monitoring, diabetes management, and drug therapy. Her work involves collaboration with other researchers such as Steven Edelman, Jeremy Pettus, and Schafer Boeder. Her research interests are aligned with improving diabetes care and advancing therapeutic strategies in primary health care settings.

Selected publications

• Continuous Glucose Monitoring–Guided Insulin Infusion in Critically Ill Patients Promotes Safety, Improves Time Efficiency, and Enhances Provider Satisfaction

  Endocrine Practice · 2025-06-23 · 4 citations

  articleOpen access

  OBJECTIVE: Evaluate the integration of real-time CGM (rtCGM) into an insulin infusion computer calculator (IICC) to improve glycemic control, time efficiency, safety, and clinician workflow in the intensive care unit (ICU). METHODS: A retrospective analysis was conducted on 35 critically ill adult patients requiring insulin infusion in the surgical and medical ICUs. Dexcom G7 rtCGM values were integrated into an institution-developed IICC using an ongoing validation protocol, allowing for nonadjunctive CGM use. The accuracy of rtCGM was assessed by comparing matched CGM and point-of-care (POC) glucose values using mean absolute relative difference (MARD), surveillance error grid, and Parkes Error Grid analyses. CGM time-in-range metrics, clinician turnaround time for glucose monitoring, and nurse satisfaction were also evaluated. RESULTS: A total of 1291 matched glucose pairs were analyzed. The rtCGM system demonstrated a MARD of 12.5%, with 99.6% of the values falling within clinically acceptable error zones (A+B) on the Parkes Error Grid. Patients in the rtCGM-IICC protocol had mean glucose 141.9 mg/dL, with mean time in range (70-180 mg/dL) 82.8%, time above range (> 180 mg/dL) 14.5%, and time below range (< 70 mg/dL) 0.5%. Clinician time efficiency improved significantly, with POC testing requiring a mean turnaround time of nearly 5 minutes compared to 3-second CGM retrieval. All surveyed nurses (n = 20) reported rtCGM increased efficiency and improved safety and preferred rtCGM with POC over POC testing alone. CONCLUSION: Integrating rtCGM with an IICC protocol in the ICU enhances glycemic control, improves workflow efficiency, and reduces clinician workload while maintaining high accuracy.

  PublisherOA PDFDOI

• Author response for "Use of continuous glucose monitoring when initiating &lt;scp&gt;glucagon‐like peptide&lt;/scp&gt;‐&lt;scp&gt;1 receptor agonist&lt;/scp&gt; therapy in insulin‐treated diabetes"

  2024-07-31

  peer-review
  PublisherDOI

• Use of continuous glucose monitoring when initiating <scp>glucagon‐like peptide</scp> ‐ <scp>1 receptor agonist</scp> therapy in insulin‐treated diabetes

  Diabetes Obesity and Metabolism · 2024-08-28 · 8 citations

  review

  Glucagon-like peptide-1 receptor agonist (GLP-1RA) medications have been shown to be effective in achieving optimal glucose control and reducing all-cause death, cardiovascular death, nonfatal myocardial infarction, hospitalization for heart failure, and end-stage kidney disease in individuals with type 1 (T1D) and type 2 diabetes (T2D). However, use of these medications has been associated with increased hypoglycaemia risk in patients treated with concomitant antihyperglycaemic medications. The risk is particularly high in patients with T1D due to their loss of glucagon counter-regulatory response. This article reviews the effect of GLP-1RA formulations on the development of hypoglycaemia in individuals with T1D and T2D treated with insulin therapy, discusses the benefits of continuous glucose monitoring with GLP-1RA treatment, and presents strategies for safely initiating GLP-1RA therapy in these individuals.

  PublisherDOI

• 169-OR: SGLT2 Inhibitor Prescribing Discrepancies in Patients with Diabetes Mellitus Type 2 and Heart Failure at an Academic Medical Center

  Diabetes · 2023-06-20

  articleSenior author

  With new indications for SGLT-2 inhibitors (SGLT2i) and efforts to minimize cardiovascular risk, there are concerns about equitable and timely distribution of SGLT2i. Inpatient initiation of SGLT2i is an important opportunity to optimize medical therapy. To better understand current prescribing practices, we compared patients started on a SGLT2i at time of discharge across two hospital sites in the 15 months after inclusion in the inpatient medication formulary. A retrospective chart review from February 2021 to May 2022 was performed of patients admitted to UC San Diego and discharged with a SGLT2i. Diagnosis was determined by ICD-10 code, and/or A1c during admission 6.5%. This cohort was compared to all patients admitted with an ICD-10 diagnosis of heart failure and/or DMT2. We examined patient demographics including age, gender, race/ethnicity, and differences between hospital sites (H1, H2). An SGLT2i was prescribed for 178 patients out of 1160 total admissions for CHF and 52,291 total admissions of individuals with DMT2. Of those who received an SGLT2i, 105 (58%) had diabetes, 151 (85%) had CHF and 82 (46%) had both. Between hospitals, 22% of patients with CHF at H1 v. 5% at H2 received an SGLT2i, and 0.22% of patients with diabetes at H1 and 0.17% at H2. The average age of those prescribed compared to the eligible population was 59 v. 64 for CHF and 60 v. 47 for DMT2. Women were less likely to be prescribed than men in both the heart failure (7% v. 16%) and DMT2 groups (0.1% v. 0.32%). The percentage of recipients (CHF, DMT2) by ethnicity was Asian (6, 0.08%), American Indian 0%, Black (7, 0.23%), Hispanic (19, 0.23%), Pacific Islander (26%, 0.81%), White 10, 0.17%). This analysis of SGLT2i initiation at hospital discharge indicates there are likely key differences in prescribing frequency between gender, ethnicities, and hospital sites. Continued collaboration amongst specialties and attention to implicit bias in prescribing practices is warranted. Disclosure J.Hansen: None. K.Kulasa: None. T.Santos cavaiola: Consultant; 9am Health.

  PublisherDOI

• Inpatient Type 1 Diabetes

  Contemporary Endocrinology · 2023-01-01 · 2 citations

  book-chapter
  PublisherDOI

• Utilizing continuous glucose monitoring in primary care practice: What the numbers mean

  Primary care diabetes · 2020-11-28 · 24 citations

  reviewCorresponding
  PublisherDOI

• Transitioning to Fixed-Ratio Combination Therapy: Five Frequently Asked Questions Health Care Providers Should Anticipate From Their Patients

  Clinical Diabetes · 2019-05-17 · 5 citations

  articleOpen accessSenior author

  A patient who is overweight with type 2 diabetes and takes multiple oral antihyperglycemic agents has been informed that the current treatment plan is not providing adequate glycemic control and that adding insulin therapy is recommended. However, the patient is concerned about insulin causing weight gain or leading to hypoglycemia and is looking for a treatment that will avoid or reduce these issues. Taking all of these considerations into account, the health care provider recommends that the patient start insulin and a glucagon-like peptide 1 (GLP-1) receptor agonist given as fixed-ratio combination (FRC) therapy administered with a prefilled pen device that allows for both basal insulin and a GLP-1 receptor agonist to be delivered in a single daily injection. Basal insulin and GLP-1 receptor agonists have different but complementary modes of action. Basal insulin predominantly regulates blood glucose between widely spaced meals and overnight (1) through the movement of glucose from blood into certain cells of the body (including skeletal muscle) and the suppression of hepatic glucose production (2); GLP-1 receptor agonists affect glucose control through glucose-dependent insulin secretion, slowing gastric emptying, inducing satiety, and suppressing excess postprandial glucagon release (3). FRC therapies that contain both a basal insulin and a GLP-1 receptor agonist have been shown to improve glycemic control with a risk of hypoglycemia that is similar to that associated with the use of basal insulin alone (4,5). In addition, FRC therapies have been shown to mitigate insulin-induced weight gain and to reduce the likelihood of the gastrointestinal (GI) adverse events that are associated with the use of GLP-1 receptor agonists. This effect is the result of slower up-titration of the GLP-1 receptor agonist component of an FRC compared with the titration schedule recommended when a GLP-1 receptor agonist is used alone (6–8). …

  PublisherOA PDFDOI

• Primary Care Management of Patients With Type 2 Diabetes: Overcoming Inertia and Advancing Therapy With the Use of Injectables

  Clinical Therapeutics · 2019-01-15 · 30 citations

  articleOpen access1st authorCorresponding
  PublisherOA PDFDOI

• Recommendations for Initiating Use of Afrezza Inhaled Insulin in Individuals with Type 1 Diabetes

  Diabetes Technology & Therapeutics · 2018-06-01 · 18 citations

  review

  (insulin human) inhalation powder in individuals with type 1 diabetes (T1D) reduces HbA1c levels similar to rapid-acting insulin analogs, but with significantly less hypoglycemia due to its unique time action profile. Examinations of studies of Afrezza pharmacokinetics/pharmacodynamics, relevant clinical trials, and U.S. Food and Drug Administration (FDA) documentation suggest that current FDA-mandated dosing recommendations for initiating Afrezza treatment may not result in optimal glycemic control for individuals with T1D. Recommendations for initiating Afrezza insulin therapy in T1D patients are presented in this article.

  PublisherDOI

• Fixed-ratio combination therapy for type 2 diabetes: the top ten things you should know about insulin and glucagon-like peptide-1 receptor agonist combinations

  Postgraduate Medicine · 2018-03-09 · 11 citations

  reviewSenior author

  Many individuals with type 2 diabetes (T2D) will eventually require insulin therapy to help achieve and maintain adequate glycemic control. However, the use of insulin can be associated with adverse effects such as hypoglycemia and weight gain, and in some patients the addition of insulin to treatment regimens is often still insufficient to achieve target glycemic control. Combining basal insulin with a glucagon-like peptide-1 receptor agonist (GLP-1 RA) for the treatment of patients with T2D has been demonstrated to be effective and well tolerated, while mitigating many of the adverse events associated with giving either of these drug classes alone. Two titratable, fixed-ratio combination therapies, iGlarLixi and IDegLira, that combine basal insulin and a GLP-1 RA in a once-daily subcutaneous injection are currently approved by the US Food and Drug Administration (FDA) for the treatment of patients with T2D. The fixed-ratio combination iGlarLixi combines insulin glargine 100 Units/mL with lixisenatide, while IDegLira combines insulin degludec 100 Units/mL with liraglutide. While these new fixed-ratio combinations contain antihyperglycemic medications that are familiar to most health care providers, there are many questions relating to their use when formulated as a fixed-ratio combination therapy. This article discusses the 'top 10' considerations that health care providers should know about these novel combination therapies as these agents begin to gain an increasing presence in clinical practice.

  PublisherDOI

Labs

• UCSD ProfilesPI