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Background: The T1DX-QI was launched in 2016 with 10 participating centers and now has over 30 U.S. endocrinology centers that share data and best practices to improve healthcare delivery and outcomes for people with T1D through the application of QI. This study aims to compare trends in A1c levels among people with T1D in the T1DX-QI registry in 2017 and 2020 across all ages. Methods: The analysis includes all T1D patients in the T1DX-QI database for whom electronic medical record data were available from clinic visits (in-person or virtual) in 2017 (N=16,683) and 2020 (N=11,575) with at least one HbA1c in each of those years. Patients aged <1 year and with T1D diagnosis <1 year were excluded. Clinics started implementing practice-wide QI projects in 2017 and have demonstrated positive change with several metrics. Results: Mean A1c in 2017, the start of the T1DX-QI data sharing and practice-wide improvements, was higher in comparison with A1c trends in 2020 (mean [SD]: 8.9[1.6] vs. 8.6[1.7]) (p<0.001). Mean A1c levels were higher in children and young adults with T1D compared to people >25 years of age. Conclusion: This study demonstrates the early success of the T1DX-QI population-based trends in HbA1c outcomes over time. While there are many contributing factors including advances in diabetes technology during this interval, improvement in A1c for sites participating in QI initiatives is encouraging. Disclosure: O. Ebekozien: None. P. Prahalad: None. O. Odugbesan: None. M. K. Kamboj: None. D. M. Maahs: Advisory Panel; Self; Abbott Diabetes, Dompe, Eli Lilly and Company, Medtronic, Novo Nordisk, Consultant; Self; aditxt. M. A. Clements: Consultant; Self; Eli Lilly and Company, Employee; Self; Glooko, Inc., Research Support; Self; Abbott Diabetes, Dexcom, Inc. T1dx-qi collaborative: n/a. N. Noor: Research Support; Self; Dexcom, Inc. N. Jones: Consultant; Self; Companion Medical, Medtronic. G. T. Alonso: None. M. Desimone: None. R. Izquierdo: None. S. Corathers: None. D. Desalvo: Consultant; Self; Insulet Corporation, Research Support; Self; Insulet Corporation, Speaker's Bureau; Self; Dexcom, Inc. N. Rioles: None. Funding: The Leona M. and Harry B. Helmsley Charitable Trust [ABSTRACT FROM AUTHOR]