Endocrine Abstracts

Up to 25% of children and young people present in diabetic ketoacidosis (DKA) at diagnosis with type 1 diabetes (T1D). The ‘4 T’s’ campaign, a national Education awareness programme, was led by Diabetes UK in 2013. Our aim was to assess the effectiveness of this campaign locally, after our team also raised local awareness by promotion to primary care.

This was a retrospective audit of referrals of children newly presenting with T1D from primary care between 2012 and 2013. The diabetes team promoted awareness of the campaign locally at the start of 2013, by contacting all primary care units via letter, posters and flyers. Data collection included: patient demographics, presenting symptoms, rapidity of GP referral and length of stay both before and after the local intervention.

In 2012, 95% (21/22) received a same day referral from primary to specialist care. 27% (6/22) patients presented in DKA. Patients in DKA had a longer length of stay (4 vs 2) days. In 2013, 90% (18/20) received a same day referral from primary to specialist care. 20% (4/22) patients presented in DKA. Patients in DKA had a longer length of stay (5 vs 3) days.

There is local awareness of the signs and symptoms for T1D amongst primary care colleagues and the need for same day referral but this is achieved in 90–95% of cases. Patients presenting in DKA reduced after the campaign had been promoted locally by the diabetes team in primary care.

A possible limiting factor for diagnosis in T1D is symptom recognition in the community setting. We intend to re-promote awareness by writing to all future referring primary care practitioners to highlight the ‘4 T’s’ campaign, with the results of this audit, as well as specific information regarding their patient.