Scholars@Duke
Susan Elizabeth Spratt

Susan Elizabeth Spratt

Professor of Medicine
Medicine, Endocrinology, Metabolism, and Nutrition
susan.spratt@duke.edu
Duke Box 3311, Duke Univesity Medical Center, Durham, NC 27710
Duke Hosp South Clinic 1A, 30 Medicine Circle, Durham, NC 27710

Scholarly Works - Journal articles

Factors Associated with Produce Prescription Program Enrollment and Benefit Use among Patients with Diabetes and at Risk for Food Insecurity.

Journal article J Nutr · June 2026 BACKGROUND: Food insecurity (FI) exacerbates type 2 diabetes (T2D) by limiting access to nutritious foods and worsening glycemic control. Produce prescription (PRx) programs subsidize fruits and vegetables to improve food security and diet quality, yet fac ... Full text Link to item Cite

About the Artist: Susan Spratt, MD.

Journal article Diabetes Care · June 1, 2026 Full text Link to item Cite

Low uptake and disparities in therapeutic inertia of cardiorenal protective diabetes medications for patients with type 2 diabetes and above-target hemoglobin A1c.

Journal article BMJ Open Diabetes Res Care · April 22, 2026 INTRODUCTION: Therapeutic inertia (failure to initiate or intensify therapy when therapeutic goals are unmet) contributes to poor glycemic control and diabetes-related complications. We assessed the extent of therapeutic inertia, defined as a lack of new p ... Full text Link to item Cite

Outpatient Direct Initiation of Injectable Buprenorphine in a Harm Reduction Agency and Primary Care Clinic: A Retrospective Case Series.

Journal article J Addict Med · April 13, 2026 OBJECTIVES: Initiating weekly long-acting injectable buprenorphine (LAIB) without prior sublingual buprenorphine ("direct-to-inject" or DTI) may reduce buprenorphine initiation barriers. In this case series, we describe outpatient DTI outcomes. METHODS: We ... Full text Link to item Cite

Produce Prescription Subsidy for Patients With Diabetes: A Pragmatic Randomized Clinical Trial.

Journal article JAMA Intern Med · April 1, 2026 IMPORTANCE: Patients with diabetes and food insecurity are at greater risk of adverse health outcomes. Effective strategies to promote healthy food access are urgently needed. OBJECTIVE: To evaluate the effect of a produce prescription (PRx) program on car ... Full text Link to item Cite

Secondary fracture prevention after vertebral, femur or pelvic fracture at US academic medical center.

Journal article Arch Osteoporos · March 5, 2026 UNLABELLED: This study sought to assess rates of osteoporosis treatment following an index fragility vertebra, femur, or pelvic fracture at a US academic medical center. The results highlight persistent low treatment rates following fracture and emphasize ... Full text Link to item Cite

SIREN 2025 National Research Meeting: Advancing the Science of Social Care

Journal article Health services research · April 1, 2025 Full text Cite

SIREN 2025 National Research Meeting: Advancing the Science of Social Care

Journal article Health services research · April 1, 2025 Full text Cite

Increasing SGLT-2 inhibitor prescribing through an integrated case-finding algorithm-guided interdisciplinary intervention.

Journal article J Am Pharm Assoc (2003) · 2025 BACKGROUND: Use of sodium-glucose cotransporter 2 inhibitors (SGLT-2 inhibitors) falls short of their cardiorenal protective benefits. Patient and provider-level barriers hinder the adoption of these life-saving medications. Innovative practices to provide ... Full text Link to item Cite

Addressing cost barriers to healthy eating with Eat Well, a prescription produce subsidy, for patients with diabetes and at risk for food insecurity: Study protocol for a type 1 hybrid effectiveness-implementation pragmatic randomized controlled trial.

Journal article Contemp Clin Trials · October 2024 BACKGROUND: Patients with diabetes at risk of food insecurity face cost barriers to healthy eating and, as a result, poor health outcomes. Population health management strategies are needed to improve food security in real-world health system settings. We ... Full text Link to item Cite

Accessibility of diabetes education in the United States: barriers, policy implications, and the road ahead.

Journal article Health Aff Sch · August 2024 Diabetes Self-Management Education and Support (DSMES) programs are an effective, yet underutilized, resource to improve health outcomes and behaviors for people with diabetes. We examined the attendance and referral rates for people with diabetes to DSMES ... Full text Link to item Cite

Improving glycemic control in diabetes through virtual interdisciplinary rounds.

Journal article Am J Manag Care · March 1, 2024 OBJECTIVE: A team-based disease management approach that considers comorbid conditions, social drivers of health, and clinical guidelines improves diabetes care but can be costly and complex. Developing innovative models of care is crucial to improving dia ... Full text Link to item Cite

Implementation of NCCARE360, a Digital Statewide Closed-Loop Referral Platform to Improve Health and Social Care Coordination: Evidence from the North Carolina COVID-19 Support Services Program.

Journal article N C Med J · March 2024 INTRODUCTION: Efforts to improve population health by being responsive to patients' social and economic conditions will benefit from care models and technologies that assess and address unmet social needs. In 2019, NCCARE360 launched in North Carolina as t ... Full text Link to item Cite

Leveraging Student Volunteers to Connect Patients with Social Risk to Resources On a Coordinated Care Platform: A Case Study with Two Endocrinology Clinics.

Journal article Int J Integr Care · 2024 INTRODUCTION: Although unmet social needs can impact health outcomes, health systems often lack the capacity to fully address these needs. Our study describes a model that organized student volunteers as a community-based organisation (CBO) to serve as a s ... Full text Link to item Cite

Interactive visualization tool to understand and monitor health disparities in diabetes care and outcomes.

Journal article J Clin Transl Sci · 2024 OBJECTIVE: Type 2 diabetes (T2DM) poses a significant public health challenge, with pronounced disparities in control and outcomes. Social determinants of health (SDoH) significantly contribute to these disparities, affecting healthcare access, neighborhoo ... Full text Link to item Cite

Comparing Patient-level Social Drivers of Health from Health Surveys and Electronic Health Records for Patients with Comorbid Hypertension and Uncontrolled Diabetes.

Journal article AMIA Annu Symp Proc · 2024 Social drivers of health significantly influence diabetes and hypertension outcomes. By taking into account patients' social and economic circumstances, healthcare systems can enhance both the quality and efficiency of care delivery, leading to improved he ... Link to item Cite

ParallelED-A novel screening and referral intervention using emergency department wait times to identify and address unmet social needs.

Journal article J Am Coll Emerg Physicians Open · December 2023 BACKGROUND: People arriving at the emergency department (ED) often have unmet health-related social needs (HRSN). We implemented an intervention that used undergraduate student volunteers to screen patients in the ED waiting room (WR) for unmet social driv ... Full text Link to item Cite

Feasibility of Electronic Health Record Integration of a SMART Application to Facilitate Patient-Provider Communication for Medication Management.

Journal article Comput Inform Nurs · August 1, 2022 Increased treatment complexity in patients with diabetes contributes to medication nonadherence. Patient portals that are accessible through electronic health records may offer improved patient-provider communication and better medication management in pat ... Full text Link to item Cite

Low-threshold Buprenorphine Treatment in a Syringe Services Program: Program Description and Outcomes.

Journal article J Addict Med · July 2022 OBJECTIVES: Low-threshold buprenorphine treatment aims to reduce barriers to evidence-based opioid use disorder treatment. We aimed to describe the treatment philosophy, practices, and outcomes of a low-threshold syringe services program (SSP)-based bupren ... Full text Link to item Cite

Impact of pharmacist outreach on glucagon prescribing.

Journal article J Am Pharm Assoc (2003) · 2022 BACKGROUND: Hypoglycemia is a major limiting factor in the glycemic management of diabetes. As a method of treating hypoglycemia, the American Diabetes Association recommends glucagon to be prescribed for all individuals at increased risk of clinically imp ... Full text Link to item Cite

General Behavioral Engagement and Changes in Clinical and Cognitive Outcomes of Patients with Type 2 Diabetes Using the Time2Focus Mobile App for Diabetes Education: Pilot Evaluation.

Journal article J Med Internet Res · January 20, 2021 BACKGROUND: Type 2 diabetes affects 30 million Americans, representing a significant cause of morbidity and mortality. Self-management support is an important component of chronic illness care and is a key pillar of the chronic care model. Face-to-face tea ... Full text Link to item Cite

Painful diabetic peripheral neuropathy: Health care costs and complications from 2010 to 2015.

Journal article Neurol Clin Pract · February 2020 OBJECTIVE: To quantify health care resource utilization and risk of complications in painful diabetic peripheral neuropathy (pDPN). METHODS: Adult patients diagnosed with diabetes mellitus or diabetic peripheral neuropathy (DPN) were identified in MarketSc ... Full text Link to item Cite

General Behavioral Engagement and Changes in Clinical and Cognitive Outcomes of Patients with Type 2 Diabetes Using the Time2Focus Mobile App for Diabetes Education: Pilot Evaluation (Preprint)

Journal article · December 18, 2019 BACKGROUNDType 2 diabetes affects 30 million Americans, representing a significant cause of morbidity and mortality. Self-management support is an important component of chronic illness c ... Full text Cite

Characteristics and Delivery of Diabetes Shared Medical Appointments in North Carolina.

Journal article N C Med J · 2019 BACKGROUND Successful diabetes care requires patient engagement and health self-management. Diabetes shared medical appointments (SMAs) are an evidence-based approach that enables peer support, diabetes group education, and medication management to improve ... Full text Open Access Link to item Cite

Research use of electronic health records: patients' perspectives on contact by researchers.

Journal article J Am Med Inform Assoc · September 1, 2018 OBJECTIVE: The use of electronic health records (EHRs) for research has the potential to improve the diagnosis and treatment of disease, yet contact with patients based on results of EHR phenotyping has received little attention. Researchers will almost ce ... Full text Link to item Cite

Substance use disorders and medical comorbidities among high-need, high-risk patients with diabetes.

Journal article Drug Alcohol Depend · May 1, 2018 BACKGROUND: The majority of the U.S. healthcare resources are utilized by a small population characterized as high-risk, high-need persons with complex care needs (e.g., adults with multiple chronic conditions). Substance use disorders (SUDs) and mental he ... Full text Open Access Link to item Cite

Medicare utilization, screening, and costs among participants in the Southeastern Diabetes Initiative: A population-based evaluation.

Journal article Prim Care Diabetes · April 2018 AIMS: Type 2 diabetes mellitus imposes significant burdens on patients and health care systems. Population-level interventions are being implemented to reach large numbers of patients at risk of or diagnosed with diabetes. We describe a population-based ev ... Full text Link to item Cite

Assessing electronic health record phenotypes against gold-standard diagnostic criteria for diabetes mellitus.

Journal article J Am Med Inform Assoc · April 1, 2017 OBJECTIVE: We assessed the sensitivity and specificity of 8 electronic health record (EHR)-based phenotypes for diabetes mellitus against gold-standard American Diabetes Association (ADA) diagnostic criteria via chart review by clinical experts. MATERIALS ... Full text Link to item Cite

Using electronic health record data for substance use Screening, Brief Intervention, and Referral to Treatment among adults with type 2 diabetes: Design of a National Drug Abuse Treatment Clinical Trials Network study.

Journal article Contemp Clin Trials · January 2016 BACKGROUND: The Affordable Care Act encourages healthcare systems to integrate behavioral and medical healthcare, as well as to employ electronic health records (EHRs) for health information exchange and quality improvement. Pragmatic research paradigms th ... Full text Open Access Link to item Cite

The agreement of patient-reported versus observed medication adherence in type 2 diabetes mellitus (T2DM).

Journal article BMJ Open Diabetes Res Care · 2016 OBJECTIVE: Medication adherence in type 2 diabetes mellitus (T2DM) improves glycemic control and is associated with reduced adverse clinical events, and accurately assessing adherence assessment is important. We aimed to determine agreement between two com ... Full text Link to item Cite

Barriers to care for patients with diabetes in Durham, North Carolina, why are we withholding life-sustaining medications from the patients who need them the most?

Journal article Expert Rev Endocrinol Metab · September 2015 The diabetes epidemic and its complications disproportionately affect minorities and the poor. Medical treatments that can prevent or delay diabetes complications are widely available but poverty underlies much of why there are disparities in diabetes care ... Full text Link to item Cite

Methods and initial findings from the Durham Diabetes Coalition: Integrating geospatial health technology and community interventions to reduce death and disability.

Journal article J Clin Transl Endocrinol · March 2015 OBJECTIVE: The Durham Diabetes Coalition (DDC) was established in response to escalating rates of disability and death related to type 2 diabetes mellitus, particularly among racial/ethnic minorities and persons of low socioeconomic status in Durham County ... Full text Link to item Cite

The implementation and evaluation of an evidence-based protocol to treat diabetic ketoacidosis: a quality improvement study.

Journal article Adv Emerg Nurs J · 2014 This retrospective observational quality improvement study was conducted to determine whether an evidence-based protocol for the treatment of diabetic ketoacidosis improved patient outcomes in our academic medical center. This study evaluated fidelity of p ... Full text Link to item Cite

A comparison of phenotype definitions for diabetes mellitus.

Journal article J Am Med Inform Assoc · December 2013 OBJECTIVE: This study compares the yield and characteristics of diabetes cohorts identified using heterogeneous phenotype definitions. MATERIALS AND METHODS: Inclusion criteria from seven diabetes phenotype definitions were translated into query algorithms ... Full text Link to item Cite

Missing signposts on the roadmap to quality: a call to improve medication adherence indicators in data collection for population research.

Journal article Front Pharmacol · 2013 PURPOSE: Poor adherence to prescribed medicines is associated with increased rates of poor outcomes, including hospitalization, serious adverse events, and death, and is also associated with increased healthcare costs. However, current approaches to evalua ... Full text Link to item Cite

Endocrinology

Journal article · December 1, 2012 Full text Cite

Effects of pregabalin on heart rate variability in patients with painful diabetic neuropathy.

Journal article J Clin Psychopharmacol · April 2011 UNLABELLED: Many studies have demonstrated that low heart rate variability (HRV) is a risk for high mortality and morbidity in patients with cardiovascular diseases. The primary purpose of the study was to evaluate whether pregabalin improves HRV in patien ... Full text Link to item Cite

Osteoporosis in lung transplant candidates compared to matched healthy controls.

Journal article Clin Transplant · 2011 PURPOSE: Advanced lung disease increases the risk for diminished bone mineral density (BMD). The prevalence and severity of osteoporosis in lung transplant candidates is unclear. METHODS: We retrospectively evaluated BMD of subjects screened for lung trans ... Full text Link to item Cite

I-131, I-123, and F-18 FDG-PET imaging in a patient with diffuse sclerosing variant of papillary thyroid cancer.

Journal article Clin Nucl Med · December 2008 PURPOSE: To compare the sensitivity of I-123 total body iodine (TBI) scan, I-131 TBI, and PET scanning with 2-deoxy-2[F-18]fluoro-D-glucose (FDG-PET) scans for detection of residual/recurrent disease in patients with diffuse sclerosing variant of papillary ... Full text Link to item Cite

Optimizing hospital use of intravenous insulin therapy: improved management of hyperglycemia and error reduction with a new nomogram.

Journal article Endocr Pract · 2005 OBJECTIVE: To assess the efficacy and safety of intravenous (IV) insulin administration with use of our institution's old protocol (pre-nomogram phase) as compared with our new insulin nomogram (post-nomogram phase), which titrates insulin dose based on th ... Full text Link to item Cite