Endocrine Abstracts

Objectives: Glycaemic targets set by diabetes teams appear to have an impact on glycaemic control. Our objective was to identify if there is consensus between and within teams in our network on glycaemic targets and whether this correlates with HbA1c outcomes.

Methods: An online survey was sent to all network members requesting an independent response on the diabetes self-management advice given to families. Three patient groups were considered: children <5 and >5 years on multiple daily injections and insulin pump therapy (CSSI). Correlation between team consensus on target HbA1c and the actual clinic mean HbA1c was investigated using Spearman’s correlation.

Results: Nineteen teams (19/20; 95%) responded with a 51% (55/108) response rate from the individual members. The response rates within teams varied from 14 to 100%. Respondents included specialist nurses (40%), dieticians (24%), senior doctors (29%), and junior doctors (7%). A target HbA1c of ≤58 mmol/mol (7.5%) was recommended by 78% (43/55) of the members for children <5 years, but by 96% (53/55) for children >5 years and CSSI group. Within individual teams, consistency in the HbA1c target was demonstrated in 54% (<5 years), 85% (>5 years), and 85% (CSII). Pre-meal blood glucose target of 4–7 mmol/l was advised by 34% (19/55), 49% (27/55), and 51% (28/55) of the members for the respective groups. The maximum variation was seen in <5 years group and pre-bed targets. The Spearman’s ρ was −0.3 indicating a small negative correlation between teams with no consensus and mean HbA1c which was not significant (P=0.37).

Conclusion: There was poor consensus between and within teams on various self-management targets especially for <5 years group and pre-bed targets. There was no significant correlation with glycaemic control, probably due to the small number of teams. We believe this survey emphasises the importance of teams having agreed written targets.