Purpose The purpose of this article is to present a framework for optimizing technology-enabled diabetes and cardiometabolic care and education using a standardized approach. This approach leverages the expertise of the diabetes care and education specialist, the multiplicity of technologies, and integration with the care team. Technology can offer increased opportunity to improve health outcomes while also offering conveniences for people with diabetes and cardiometabolic conditions. The adoption and acceptance of technology is crucial to recognize the full potential for improving care. Understanding and incorporating the perceptions and behaviors associated with technology use can prevent a fragmented health care experience. Conclusion Diabetes care and education specialists (DCES) have a history of utilizing technology and data to deliver care and education when managing chronic conditions. With this unique skill set, DCES are strategically positioned to provide leadership to develop and deliver technology-enabled diabetes and cardiometabolic health services in the rapidly changing healthcare environment.

Despite advances in diabetes therapies and technologies, the majority of people with diabetes (PWD) are not achieving treatment targets.Therapeutic inertia has been identified as a key contributor, and although multifactorial, a major obstacle to timely therapy optimization is the lack of access to data. 1 The increasing use of connected diabetes digital technologies that automatically record, share, and increasingly interpret diabetes-related data can facilitate more timely and better informed care plan adjustments made in collaboration with the person living with diabetes. 2 The American Diabetes Association Standards of Medical Care in Diabetes opens the Diabetes Technology chapter stating, "there is no one-size-

Fig. 1. Contrast computer tomotgraphy of the brain showing bilateral symmetrical thalamic hypodensity with volumetric expansion.

Background. Spinal muscular atrophy (SMA) is an autosomal recessive neuromuscular disorder that is present in all populations andresults in muscle weakness owing to anterior horn cell degeneration. SMA is divided into three clinical subtypes and is an importantgenetic cause of morbidity and mortality but has not been well studied in sub-Saharan Africa.Objective. This study aims to describe the clinical features and genetic findings in black patients with SMA presenting to the Division ofPaediatric Neurology at Chris Hani Baragwanath Academic Hospital (CHBAH) over a 30-year period.Method. This study was a retrospective review of patient records. The study population was black paediatric neurology patients withclinical SMA, who attended CHBAH Neurology Clinic between 1988 and 2018. Patients were categorised into SMA type 1, 2 or 3 basedon their neurology assessment and clinical features were recorded.Results. The clinical findings in the study population (with SMA), i.e. hypotonia, areflexia and tongue fasciculations, were similar to those found in international studies. More than half of the patients (65.6%; n=86/131) had genetic tests, of which 84.8% were positive for SMA. This value was significantly higher than previously reported results from South Africa. At least 23.6% (n=31/131) had facial involvement.Conclusions. This study adds to the limited body of research on SMA in sub-Saharan Africa and highlights the lower frequency of ahomozygous deletion seen in the black South African population compared with the expected 95% worldwide.