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Endocrine Abstracts (2012) 28 P230

Endocrinology, Portiuncula Hospital, Ballinasloe, Ireland.


In Ireland, we are devolving management of diabetes to primary care. Recent studies highlight the importance of early glycemic (metabolic memory) & multifactorial control. Our hospital‘new’patient waiting lists average 18 months and for ‘best practice’, this is “time lost”. We established a pilot program for a rapid assessment to reduce waiting times and ensure specialist input. This is a retrospective review of our 50 patients thus far. 30% were women and 70% male. 6% had DM1, 94% had DM2. 8% of patients were aged <40 years, 52% were 41–60 years; 32% were 61–75 and 4% were over 75 (60% of cohort aged <60 years.) 12% of patients had normal BMI, 78% were overweight/obese and 10% were super-obese. 58% were diagnosed within the previous 2 years,and a further 10% within 2–5 years, 16% within 5–10 years. 16% had DM for over 10 year. 22% had an HbA1c of <6.5%, and a further 14% of 6.5–7%.74% had an HbA1c exceeding recommended targets of 7%. 15% had an HbA1c of 7–8%, 22% and HbA1c of 8–10%, and 37% exceeding 10%. The average HbA1c was 8.2% in those with duration of DM <1 year, trending up to 8.5% with duration of <2 years. 30% had undiagnosed complications. 2% had retinopathy, 16% had neuropathy, 12% had nephropathy (Avg A1c of 7.67% in those with low eGFR vs 7.18% without, and 8.74% in with micro albuminuria vs 8.1% in those without) 52% had treated hypertension.76% of patients had BP readings exceeding the guidelines of 130/80 and 64% exceeded 140/90, of whom 24.1% only were on treatment. 56% had treated hyperlipidemia, but 68% had LDL values >2.0 mmol (74%>1.8 mmol). In summary, patients are young, obese and have poor control. Almost 75% exceed recommended HbA1c targets, which is ‘time lost’. Almost 75% have poor BP control; almost 70% have poor lipid control, and those on treatment are inadequately treated. This emphasizes the concern of delegation of management without a defined algorithm that must serve as a regular checklist for care.

Declaration of interest: There is no conflict of interest that could be perceived as prejudicing the impartiality of the research reported.

Rapid Assessment Data vs ADOPT Data

Funding: No specific grant from any funding agency in the public, commercial or not-for-profit sector.

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