Endocrine Abstracts

Background: The incidence of type 2 diabetes in childhood in the UK is increasing. It is often an aggressive disease associated with poor health outcomes. Despite this, there is little formal training and evidence based guidance.

Objectives and method: A questionnaire was sent to each paediatric diabetes unit in England and Wales, evaluating variation in practice, training and confidence in the management of type 2 diabetes.

Results: • 83 out of 173 units responded, including tertiary centers and district general hospitals and incorporating different professionals within the multidisciplinary team.

• Most centers – 62%, provided care for relatively few (between 0 and 4) patients with type 2 diabetes.

• There was a wide variation on service and care provision between centres. For example the guidelines being used, with 18% were uncertain if they were following guidelines or not. A minority were offering a structured education program. 8% offered separate clinics for Type 2 diabetes and 30% had access to healthy eating and exercise programs.

• 70% did not have formal training in managing type 2 diabetes and 76% felt under-confident in managing the condition.

• 60%, rated their service’s impact on quality of life and health of patients as a small positive or none at all.

• One in five units said their team had

– no formal training,

– low confidence,

– little or no support from adult services.

Respondents requested:

• Further education and training. Popular suggestions were:

• Network events, a national training program and team training events.

• Evidence based national guidelines.

Conclusions: The majority of children with type 2 diabetes are cared for in centers that have small patient numbers highlighting the need for sharing good practice, training and guidelines. There is wide variation in the services offered to children with type 2 diabetes across England and Wales with the most units having no formal training. Consequently the majority of respondents rated their confidence as low. This survey highlights the need for standardisation of care and service provision with nationally accredited guidelines training program in order to help improve outcomes.