Introduction: We evaluated the Lothian Adolescent Diabetes Service (LADS) to assess the service at the introduction of a clinical psychologist, to help guide service redevelopment and evaluate areas where psychological support would be most beneficial.
Methods: Over 13 weeks, all adolescents with type 1 diabetes mellitus attending LADS clinics were invited to complete a questionnaire about their clinic experience and support with diabetes management. Consent was requested to use data from their medical records, including HbA1C to allow evaluation of glycaemic control. Clinic attendance statistics over the study and preceding year were also recorded.
Results: 72% of adolescents had a good/very good clinic experience and clinic attendance over 1 year was high (83.3%). However, 76% spent ≥1 h at clinic whilst 78% spent ≥50% of their visit waiting. The majority ranked the doctor as most important person to consult at clinic and dietician the least. 47.6% receive a lot of help with diabetes management but 77% want no change in responsibility. Mood was the topic most frequently requested for additional information and support. Only 10.7% of the adolescents had a mean HbA1C <7.5% (target HbA1C) over 1 year. Worryingly, a third of adolescents with HbA1C >9.0% perceived their glycaemic control as moderate to very good.
Conclusions: LADS provides a satisfactory service and support for adolescents. However, glycaemic control is suboptimal, which adolescents may not realise; increasing awareness should be prioritised. Recommended foci for service-wide development include reducing total and waiting clinic durations and development of dietician/psychologist roles.
09 - 11 Nov 2011
British Society for Paediatric Endocrinology and Diabetes